Provider Demographics
NPI:1134228695
Name:WOO, CRAIGHTON BRIAN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CRAIGHTON
Middle Name:BRIAN
Last Name:WOO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 26TH ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-2542
Mailing Address - Country:US
Mailing Address - Phone:310-458-6769
Mailing Address - Fax:310-319-9112
Practice Address - Street 1:240 26TH ST
Practice Address - Street 2:SUITE #2
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90402-2542
Practice Address - Country:US
Practice Address - Phone:310-458-6769
Practice Address - Fax:310-319-9112
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics