Craig S Ward, LD
Individual provider Active NPI Denturist · Stayton, OR
NPI 1831752823 · NPPES record last updated Apr 16, 2019
Key facts
- NPI
- 1831752823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Denturist 122400000X
- License
- DT-DO-10195126 (OR)
- Practice address
- 521 N 1St Ave
Stayton, OR 97383-1703 - Phone
- (503) 769-9699
- NPI assigned
- Apr 16, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT-DO-10195126 | OR | MD | Denturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Dental Group, PC | Past | Accepting new patients | |
| Advantage Dental Group, PC | Past | Accepting new patients | |
| Mill Creek Dental, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | DT-DO-10195126 | OR | Yes |
Addresses
Primary practice location
521 N 1St Ave
Stayton, OR 97383-1703
Mailing address
PO Box 11470
Eugene, OR 97440-3670
Phone (888) 468-0022
Other providers in Stayton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.