Provider Demographics
NPI:1356564678
Name:MABRITO, CRAIG A (DDS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:MABRITO
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 1:1233 WEST LOOP SOUTH, SUITE 1225
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027
Mailing Address - Country:US
Mailing Address - Phone:713-528-0567
Mailing Address - Fax:713-528-2176
Practice Address - Street 1:1233 WEST LOOP S STE 1225
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9112
Practice Address - Country:US
Practice Address - Phone:713-528-0567
Practice Address - Fax:713-528-2176
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice