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Craig H Fountain, DDS
Oral and Maxillofacial Surgery (Dentist) in Traverse City, Michigan
NPI 1992759625

Craig H Fountain is a Oral and Maxillofacial Surgery (Dentist) based in Traverse City, MI and is specialized in Oral and Maxillofacial Surgery. Craig H Fountain practices in Traverse City, MI and has the professional credentials of DDS. The NPI Number for Craig H Fountain is 1992759625 and holds a License No. 2901018208 (Michigan).

The current practice location address for Craig H Fountain is 12776 S West Bay Shore Dr, Traverse City, MI and can be reached out via phone at 231-946-3512 and via fax at 231-946-1908.

Location: 12776 S West Bay Shore Dr, Traverse City, MI, 49684-3234
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992759625
Provider Name
Craig H Fountain
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
12776 S West Bay Shore Dr, Traverse City, MI, 49684-3234
Phone Number
231-946-3512
Fax Number
231-946-1908
Provider Enumeration Date
05/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4756423 05 MI
1003095605 01 MI NPI GROUP #
4756432 05 MI
institution
Provider Business Practice Location Address Details
Address
12776 S West Bay Shore Dr
City
Traverse City
State
Michigan
Zip
49684-5451
Phone Number
231-946-3512
Fax Number
231-946-1908
person
Provider Business Mailing Address Details
Address
12776 S West Bay Shore Dr
City
Traverse City
State
Michigan
Zip
49684-5451
Phone Number
231-946-3512
Fax Number
231-946-1908
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
2901018208 (Michigan)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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