MEDICARE: DR. CRAIG A MABRITO DDS

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	1223G0001X	General Practice Dentistry	10141	TX

General Provider Information

NPI Number	:	1356564678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG A MABRITO DDS

Provider Business Mailing Address
First Line	:	1233 WEST LOOP SOUTH, SUITE 1225
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027
Country	:	US
Telephone Number	:	713-528-0567
Fax Number	:	713-528-2176

Provider Business Practice Location Address
First Line	:	1233 WEST LOOP S STE 1225
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-9112
Country	:	US
Telephone Number	:	713-528-0567
Fax Number	:	713-528-2176

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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