MEDICARE: DR. CRAIG STANLEY SAWKA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901010951	MI

General Provider Information

NPI Number	:	1326129826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG STANLEY SAWKA D.D.S.

Provider Business Mailing Address
First Line	:	7777 IVES AVE
Second Line	:
City	:	GROSSE ILE
State	:	MI
Zip	:	48138-1004
Country	:	US
Telephone Number	:	734-671-1664
Fax Number	:

Provider Business Practice Location Address
First Line	:	2325 GARFIELD RD N # C
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5127
Country	:	US
Telephone Number	:	231-932-7316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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