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General NPI Number Information
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NPI Number | 1427762517
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Entity Type | Organization
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Legal Business Name | CRAIG S MARTIN DMD PLLC
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 2000 VERMONT DR STE 200
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City | FORT COLLINS
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State | CO
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Zip | 80525-2900
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Country | US
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Telephone | 512-887-0232
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 MASTERS CT
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City | SUPERIOR
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State | CO
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Zip | 80027-8158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | CRAIG MARTIN
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Credential | DMD
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Telephone | 512-887-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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