Michael Kale Craig, DDS
Individual provider Active NPI General Practice Dentistry · Wagoner, OK
NPI 1871613596 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1871613596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5069 (OK)
- Practice address
- 900 E Cherokee St
Wagoner, OK 74467-4718 - Phone
- (918) 485-2200
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 5069 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wagoner Family Dentistry, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5069 | OK | Yes |
Addresses
Primary practice location
900 E Cherokee St
Wagoner, OK 74467-4718
Mailing address
900 E Cherokee St
Wagoner, OK 74467-4718
Phone (918) 485-2200
Other providers in Wagoner, OK
- Harry O Colbert III
- Myrtle L Collins
- Ethan Garret Colwell
- Sandra Cooper
- Rebecca Costello Shetlar
- Regenna Craig
- Debra Ann Crawford
- Michael Ellis Crawford
- Jennifer Grace Crawley
- Creoks Mental Health Services
All providers in Wagoner, OK · General Practice Dentistry in Oklahoma
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.