Healthcare Provider Details

I. General information

NPI: 1376094136
Provider Name (Legal Business Name): CRAIG DORION DDS MPH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MARTIN LUTHER KING JR BLVD
CHAPEL HILL NC
27514-2619
US

IV. Provider business mailing address

920 MARTIN LUTHER KING JR BLVD
CHAPEL HILL NC
27514-2619
US

V. Phone/Fax

Practice location:
  • Phone: 919-967-5099
  • Fax:
Mailing address:
  • Phone: 919-967-5099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number8503
License Number StateNC

VIII. Authorized Official

Name: DR. CRAIG DORION
Title or Position: PRESIDENT
Credential: DDS
Phone: 919-621-0183