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General NPI Number Information
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NPI Number | 1285825729
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Entity Type | Organization
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Legal Business Name | CRAIG V. DUREN, D.D.S. , P.A.
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 351 W NICOLLET BLVD
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City | BURNSVILLE
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State | MN
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Zip | 55337-4568
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Country | US
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Telephone | 952-435-4142
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Fax | 952-435-4187
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Provider Business Mailing Address
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Address Line | 351 W NICOLLET BLVD
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City | BURNSVILLE
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State | MN
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Zip | 55337-4568
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Country | US
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Telephone | 952-435-4142
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Fax | 952-435-4187
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRAIG VERNON DUREN
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Credential | DDS
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Telephone | 952-435-4142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10619
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License Number State | MN
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