Provider Demographics
NPI:1548713167
Name:CRAIG M. GAYTON DDS P.C.
Entity type:Organization
Organization Name:CRAIG M. GAYTON DDS P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-681-4812
Mailing Address - Street 1:3060 MITCHELLVILLE RD
Mailing Address - Street 2:SUITE108
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1389
Mailing Address - Country:US
Mailing Address - Phone:240-245-3174
Mailing Address - Fax:888-784-1551
Practice Address - Street 1:10801 LOCKWOOD DR
Practice Address - Street 2:240
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1556
Practice Address - Country:US
Practice Address - Phone:301-681-4812
Practice Address - Fax:888-784-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty