Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MICHAEL RAYMOND CRADDOCK, DDS
ActiveDR. MICHAEL RAYMOND CRADDOCK, DDS is a Pediatric Dentistry healthcare provider located in KIRTLAND AFB, New Mexico. NPI 1871541276 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · KIRTLAND AFB, NM
Registration Details
- NPI Number
- 1871541276
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 5, 2006 (20.273804666033 yrs)
- Last Updated
- Apr 14, 2021
- Licenses
-
DD5009 (NM)14481 (TX)14481 (TX)DEN.00009325 (CO)DEN.00009325 (CO)
Practice Information
- Address
-
2050A 2ND ST SEKIRTLAND AFB, NM, 871175901Browse NM providers · Browse ZIP 87117
- Phone
- 5058463200
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
- Additional Specialty
- General Dentistry
- Additional Specialty
- Pediatric Dentistry
- Additional Specialty
- Pediatric Dentistry
- Additional Specialty
- Dentist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.