Crum, W Dale

Crum, W Dale is an sole proprietor health care provider with primary practice located at 2204 E 29Th Ave Ste 104, Spokane WA 99203-3961. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Crum, W Dale can be contacted via phone (509) 928-8800.

Contact Information

Primary practice address
2204 E 29Th Ave Ste 104 Spokane WA 99203-3961
Fax: (509) 321-0154
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 7006 Washington

Profile Details

NPI number 1609870070
LBN Legal business name Crum, W Dale
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2005
Last updated Apr 15th, 2010 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1609870070 NPPES
Washington MEDICAID 5026117

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