Craddock, Michael Raymond

Craddock, Michael Raymond is an individual health care provider with primary practice located at 2050A 2Nd St Se , Kirtland Afb NM 87117-5901. He recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice, Dental Providers / Prosthodontics. Dental Providers / Prosthodontics is his primary health care specialty. Craddock, Michael Raymond can be contacted via phone (505) 846-3200.

Contact Information

Primary practice address
2050A 2Nd St Se Kirtland Afb NM 87117-5901
Phone: (505) 846-3200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DD5009 New Mexico
Dental Providers / General Practice 1223G0001X 14481 Texas
Dental Providers / Prosthodontics 1223P0700X 14481 Texas
Dental Providers / Prosthodontics 1223P0700X DEN.00009325 Colorado
Dental Providers / Dentist 122300000X DEN.00009325 Colorado

Profile Details

NPI number 1871541276
LBN Legal business name Craddock, Michael Raymond
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Apr 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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