Provider Demographics
NPI:1053359646
Name:SPAULDING, CRAIG D (DDS,PC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:SPAULDING
Suffix:
Gender:M
Credentials:DDS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4350
Mailing Address - Country:US
Mailing Address - Phone:405-372-1155
Mailing Address - Fax:405-372-1155
Practice Address - Street 1:823 S PINE ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4350
Practice Address - Country:US
Practice Address - Phone:405-372-1155
Practice Address - Fax:405-372-1155
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK44941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice