Provider Demographics
NPI:1447492616
Name:KRAFT, IRVING A (DDS)
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:A
Last Name:KRAFT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 PHILMONT AVENUE
Mailing Address - Street 2:FAIRWAY PLAZA - SUITE 114
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006
Mailing Address - Country:US
Mailing Address - Phone:215-947-4910
Mailing Address - Fax:215-947-1494
Practice Address - Street 1:2600 PHILMONT AVENUE
Practice Address - Street 2:FAIRWAY PLAZA - SUITE 114
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006
Practice Address - Country:US
Practice Address - Phone:215-947-4910
Practice Address - Fax:215-947-1494
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA19370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist