Healthcare Provider Details

I. General information

NPI: 1932558186
Provider Name (Legal Business Name): CRAIG M MULHERIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CLEVELAND AVE
MONETT MO
65708-1265
US

IV. Provider business mailing address

800 E CLEVELAND AVE
MONETT MO
65708-1265
US

V. Phone/Fax

Practice location:
  • Phone: 417-235-5155
  • Fax:
Mailing address:
  • Phone: 417-235-5155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2016018486
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: