MEDICARE: DR. EDWARD CRACIUN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	27727	FL
2	122300000X	Dentist	600101415	WI
3	122300000X	Dentist	D15404	MN
4	122300000X	Dentist	2024003610	MO

General Provider Information

NPI Number	:	1093446890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD CRACIUN DMD

Provider Business Mailing Address
First Line	:	14645 SUTHERLAND AVE
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-4116
Country	:	US
Telephone Number	:	239-776-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	4273 W CIRCLE DR NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-8788
Country	:	US
Telephone Number	:	507-332-1886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	01/02/2026

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