Healthcare Provider Details

I. General information

NPI: 1477605509
Provider Name (Legal Business Name): GREGORY CRAFT D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 13TH AVE STE 200
HUNTINGTON WV
25701-3840
US

IV. Provider business mailing address

2154 CARTER AVE SUITE A
ASHLAND KY
41101-7739
US

V. Phone/Fax

Practice location:
  • Phone: 304-691-1247
  • Fax: 304-691-1248
Mailing address:
  • Phone: 606-324-6494
  • Fax: 606-325-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number6714, 601
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4284
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: