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:
Health care specialties
| Specialty | Code | License # | 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 5 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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