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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150716002311 | PA | Order and Referring Only - Dentist |
2466765656 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS021812L | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Folsom, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.