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General NPI Number Information
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NPI Number | 1164680245
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Entity Type | Organization
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Legal Business Name | CRAIG A. YOUNG, DMD PLLC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 2820 N GLASSFORD HILL RD STE 102
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2256
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Country | US
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Telephone | 928-775-8448
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 N GLASSFORD HILL RD STE 102
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2256
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Country | US
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Telephone | 928-775-8448
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | CRAIG A YOUNG
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Credential | DMD
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Telephone | 928-775-8448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7399
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License Number State | AZ
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