| NPI | 1124282207 |
|---|---|
| Other Name | JAKE DAVID CRAGUN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: TX 25238) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: FL 679) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2012-09-07 |