Provider Demographics
NPI:1174583850
Name:ALLISON, CRAIG EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:EDWARD
Last Name:ALLISON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CRAIG
Other - Middle Name:EDWARD
Other - Last Name:ALLISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:15 AVIEMORE DR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9797
Mailing Address - Country:US
Mailing Address - Phone:910-295-4343
Mailing Address - Fax:910-295-3913
Practice Address - Street 1:15 AVIEMORE DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9797
Practice Address - Country:US
Practice Address - Phone:910-295-4343
Practice Address - Fax:910-295-3913
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3527122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3527OtherDENTAL LISCENSE