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General NPI Number Information
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NPI Number | 1306177241
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Entity Type | Organization
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Legal Business Name | DENTAL SLEEP CENTER RICHARD A CRAIG DDS LTD
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 2500 S HIGHLAND AVE STE 220
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City | LOMBARD
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State | IL
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Zip | 60148-7103
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Country | US
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Telephone | 630-218-1920
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Fax | 815-744-7059
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Provider Business Mailing Address
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Address Line | 14831 W 159TH ST STE 1
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City | LOCKPORT
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State | IL
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Zip | 60491-9008
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Country | US
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Telephone | 630-218-1920
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Fax | 815-744-7059
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD ALLEN CRAIG
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Credential | D.D.S.
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Telephone | 815-483-2980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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