Provider Demographics
NPI:1487746798
Name:CRUMRINE, PAMELA G (DDS)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:G
Last Name:CRUMRINE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2026
Mailing Address - Country:US
Mailing Address - Phone:724-775-4860
Mailing Address - Fax:724-775-7543
Practice Address - Street 1:1040 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2026
Practice Address - Country:US
Practice Address - Phone:724-775-4860
Practice Address - Fax:724-775-7543
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027177L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA608847Medicare UPIN