Provider Demographics
NPI:1174091680
Name:DAVID CRANK DDS PA
Entity type:Organization
Organization Name:DAVID CRANK DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-444-2917
Mailing Address - Street 1:436 CROSSMOR DR
Mailing Address - Street 2:
Mailing Address - City:TODD
Mailing Address - State:NC
Mailing Address - Zip Code:28684-9141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:895 STATE FARM RD STE 302
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4917
Practice Address - Country:US
Practice Address - Phone:828-386-1303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental