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1992759625
CRAIG H FOUNTAIN
TRAVERSE CITY, MI
NPI
1992759625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: MI 2901018208)
Enumeration Date
2006-05-19
Last Update Date
2007-12-27
Business Address
-- CRAIG H FOUNTAIN dds
12776 S WEST BAY SHORE DR
TRAVERSE CITY, MI 49684-5451
Phone number: 231-946-3512
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Mailing Address
-- CRAIG H FOUNTAIN dds
1010 CASS ST
TRAVERSE CITY, MI 49684-3234
Phone number: 231-392-5810
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