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General NPI Number Information
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NPI Number | 1548713167
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Entity Type | Organization
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Legal Business Name | CRAIG M. GAYTON DDS P.C.
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 10801 LOCKWOOD DR 240
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City | SILVER SPRING
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State | MD
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Zip | 20901-1556
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Country | US
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Telephone | 301-681-4812
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Fax | 888-784-1551
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Provider Business Mailing Address
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Address Line | 3060 MITCHELLVILLE RD SUITE108
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City | BOWIE
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State | MD
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Zip | 20716-1389
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Country | US
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Telephone | 240-245-3174
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Fax | 888-784-1551
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRAIG M GAYTON
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Credential | D.D.S.
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Telephone | 301-681-4812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 12438
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License Number State | MD
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