MEDICARE: DR. GREGORY CRAFT D.M.D.

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	1223P0300X	Periodontics	6714, 601	KY
2	1223P0300X	Periodontics	4284	WV

General Provider Information

NPI Number	:	1477605509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY CRAFT D.M.D.

Provider Business Mailing Address
First Line	:	2154 CARTER AVE
Second Line	:	SUITE A
City	:	ASHLAND
State	:	KY
Zip	:	41101-7739
Country	:	US
Telephone Number	:	606-324-6494
Fax Number	:	606-325-4144

Provider Business Practice Location Address
First Line	:	1616 13TH AVE STE 200
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3840
Country	:	US
Telephone Number	:	304-691-1247
Fax Number	:	304-691-1248

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/12/2025

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