Provider Demographics
NPI:1295948768
Name:WEST, CRAIG REED (DDS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:REED
Last Name:WEST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 S. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SNOWFLAKE
Mailing Address - State:AZ
Mailing Address - Zip Code:85937-5247
Mailing Address - Country:US
Mailing Address - Phone:928-536-4182
Mailing Address - Fax:928-536-4182
Practice Address - Street 1:439 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SNOWFLAKE
Practice Address - State:AZ
Practice Address - Zip Code:85937-5247
Practice Address - Country:US
Practice Address - Phone:928-536-4182
Practice Address - Fax:928-536-4182
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2313122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist