Craig Otto Preis, DDS

Individual provider Active NPI General Practice Dentistry · Folsom, PA

NPI 1477612489 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1477612489
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS021812L (PA)
Practice address
217 Kedron Ave
Folsom, PA 19033-1310
Phone
(610) 532-0984
Fax
(610) 532-0869
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
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
I20150716002311 PA Order and Referring Only - Dentist
Practitioner - Dentist
2466765656

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DS021812LPAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS021812L PA Yes

Addresses

Primary practice location

217 Kedron Ave
Folsom, PA 19033-1310

Mailing address

3081 Green Valley Rd
Newtown Square, PA 19073-4312
Phone (610) 353-3379

Other providers in Folsom, PA

All providers in Folsom, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.