Crandall, Jeffrey Allen
Crandall, Jeffrey Allen is an individual health care provider with primary practice located at 40 Timber Ln , South Burlington VT 05403-7204. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Crandall, Jeffrey Allen can be contacted via phone (802) 862-7185.Contact Information
Primary practice address
40 Timber Ln
South Burlington VT 05403-7204
Phone: (802) 862-7185
Fax: (802) 658-8036
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | 615 | Vermont |
Profile Details
| NPI number | 1790711414 |
|---|---|
| LBN Legal business name | Crandall, Jeffrey Allen |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790711414 | NPPES |
| Vermont | MEDICAID | 0001847 |
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