MEDICARE: DR. DAVID A. CRAFT 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	7196	KS

General Provider Information

NPI Number	:	1417084104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A. CRAFT DDS

Provider Business Mailing Address
First Line	:	340 W 7TH ST
Second Line	:
City	:	JUNCTION CITY
State	:	KS
Zip	:	66441-3054
Country	:	US
Telephone Number	:	784-223-4210
Fax Number	:	785-223-0579

Provider Business Practice Location Address
First Line	:	340 W 7TH ST
Second Line	:
City	:	JUNCTION CITY
State	:	KS
Zip	:	66441-3054
Country	:	US
Telephone Number	:	784-223-4210
Fax Number	:	785-223-0579

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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