Provider Demographics
NPI:1760043202
Name:ANDERSON, CRAIG W (DMD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:W
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 N NEW ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2400
Mailing Address - Country:US
Mailing Address - Phone:610-861-7406
Mailing Address - Fax:
Practice Address - Street 1:1275 S CEDAR CREST BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6242
Practice Address - Country:US
Practice Address - Phone:612-624-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0445111223S0112X, 1223S0112X
MND142751223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery