MEDICARE: DR. CRAIG S SHAPIRO 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	1223G0001X	General Practice Dentistry	12565	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730138041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG S SHAPIRO DMD

Provider Business Mailing Address
First Line	:	2831 MIDWAY RD SE STE 116
Second Line	:
City	:	BOLIVIA
State	:	NC
Zip	:	28422-8377
Country	:	US
Telephone Number	:	910-408-4436
Fax Number	:

Provider Business Practice Location Address
First Line	:	2831 MIDWAY RD SE STE 116
Second Line	:
City	:	BOLIVIA
State	:	NC
Zip	:	28422-8377
Country	:	US
Telephone Number	:	910-408-4436
Fax Number	:

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

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	07/31/2024

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