Crane, Mark Allen
Crane, Mark Allen is an sole proprietor health care provider with primary practice located at 1635 S Plaza Way , Flagstaff AZ 86001-7102. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Crane, Mark Allen can be contacted via phone (928) 214-7052.Contact Information
Primary practice address
1635 S Plaza Way
Flagstaff AZ 86001-7102
Phone: (928) 214-7052
Fax: (928) 214-7059
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D4371 | Arizona |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | OMS27 | California |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 26402 | Arizona |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | A064888 | California |
Profile Details
| NPI number | 1760531644 |
|---|---|
| LBN Legal business name | Crane, Mark Allen |
| Credentials | M.D., D.D.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2007 |
| 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 | 1760531644 | NPPES |
| Arizona | MEDICAID | 545345 |
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