Provider Demographics
NPI:1013960509
Name:JOHN C CRAIGER DDS PC
Entity Type:Organization
Organization Name:JOHN C CRAIGER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CRAIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-758-5252
Mailing Address - Street 1:7090 EAST HAMPDEN AVE
Mailing Address - Street 2:DR JOHN C CRAIGER
Mailing Address - City:DEVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3022
Mailing Address - Country:US
Mailing Address - Phone:303-758-5252
Mailing Address - Fax:303-691-1937
Practice Address - Street 1:7090 EAST HAMPDEN AVE
Practice Address - Street 2:DR JOHN C CRAIGER
Practice Address - City:DEVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3022
Practice Address - Country:US
Practice Address - Phone:303-758-5252
Practice Address - Fax:303-691-1937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO08221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty