Individual
JARED CRUTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3740 E LAKE CTR, QUINCY, IL 62305-5805
(217) 214-4545
Mailing address
1031 KENTUCKY ST, QUINCY, IL 62301-4211
(618) 402-8890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.033129
IL
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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