Mark Griffiths, D.D.S.

Individual provider Active NPI General Practice Dentistry · Crawford, NE

NPI 1306167408 · NPPES record last updated Jul 14, 2011

Key facts

NPI
1306167408
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6878 (NE)
Practice address
705 1St St
Crawford, NE 69339-1186
Phone
(308) 233-5855
NPI assigned
Jun 13, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150522001306 NE Order and Referring Only - Dentist
Practitioner - Dentist
2860712304

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6878NEMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6878 NE Yes

Addresses

Primary practice location

705 1St St
Crawford, NE 69339-1186

Mailing address

705 1St St
Crawford, NE 69339-1186

Other providers in Crawford, NE

All providers in Crawford, NE · General Practice Dentistry in Nebraska

Sources for this page

Verify at the official NPI Registry.