Crandall Cruz, Marissa

Crandall Cruz, Marissa is an sole proprietor health care provider with primary practice located at 26540 Ace Ave , Leesburg FL 34748-8279. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Periodontics. Dental Providers / Periodontics is her primary health care specialty. Crandall Cruz, Marissa can be contacted via phone (352) 326-4404.

Contact Information

Primary practice address
26540 Ace Ave Leesburg FL 34748-8279
Phone: (352) 326-4404
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DS039658 Pennsylvania
Dental Providers / Periodontics 1223P0300X DN23797 Florida

Profile Details

NPI number 1194123638
LBN Legal business name Crandall Cruz, Marissa
Credentials D.M.D., M.S
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 16th, 2014
Last updated Dec 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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