MEDICARE: DR. CRAIG D MUKAI 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	1223P0300X	Periodontics	24686	CA

General Provider Information

NPI Number	:	1932114139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG D MUKAI D.D.S.

Provider Business Mailing Address
First Line	:	5 CADDY CT
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94949-5862
Country	:	US
Telephone Number	:	415-884-0577
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 SUTTER ST
Second Line	:	SUITE 2329
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4206
Country	:	US
Telephone Number	:	415-397-4095
Fax Number	:	415-397-4050

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

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. CRAIG D MUKAI D.D.S.” Practice Location

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