Provider Demographics
NPI:1245344324
Name:SOFFIN, CRAIG BARRY (DMD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BARRY
Last Name:SOFFIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1431
Mailing Address - Country:US
Mailing Address - Phone:610-337-0110
Mailing Address - Fax:610-337-2102
Practice Address - Street 1:491 ALLENDALE ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1431
Practice Address - Country:US
Practice Address - Phone:610-337-0110
Practice Address - Fax:610-337-2102
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019971L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics