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General NPI Number Information
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NPI Number | 1386156446
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Entity Type | Individual
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Provider Name | CHARLES FREDERICK CRAFT DDS
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Gender | Male
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 301 CENTENNIAL MALL S
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City | LINCOLN
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State | NE
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Zip | 68508-2529
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Country | US
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Telephone | 402-471-4599
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Fax | 402-471-6446
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Provider Business Mailing Address
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Address Line | DHHS NEBRASKA OFFICE OF ORAL HEALTH AND DENTISTRY 301 CENTENNIAL MALL SOUTH
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City | LINCOLN
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State | NE
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Zip | 68509-5026
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Country | US
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Telephone | 402-471-4599
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Fax | 402-471-6446
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4891
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License Number State | NE
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