Provider Demographics
NPI:1336244995
Name:SPANGLER, CRAIG CARLTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:CARLTON
Last Name:SPANGLER
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 1:3953 COTTONTAIL LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1909
Mailing Address - Country:US
Mailing Address - Phone:248-561-3507
Mailing Address - Fax:
Practice Address - Street 1:4050 W MAPLE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3148
Practice Address - Country:US
Practice Address - Phone:248-645-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI121581223G0001X
MI29010121581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice