Provider Demographics
NPI:1801808787
Name:CRAIG J. PLAHN DDS PC
Entity type:Organization
Organization Name:CRAIG J. PLAHN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-965-7222
Mailing Address - Street 1:132 W WASHINGTON AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3978
Mailing Address - Country:US
Mailing Address - Phone:314-965-7222
Mailing Address - Fax:
Practice Address - Street 1:132 W WASHINGTON AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-3978
Practice Address - Country:US
Practice Address - Phone:314-965-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO139221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty