Individual
DR. BRIAN RICHARD CROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
755 BOARDMAN CANFIELD RD, SOUTHBRIDGE WEST BUILDING L-1, BOARDMAN, OH 44512-4300
(330) 758-7750
Mailing address
755 BOARDMAN CANFIELD RD, SOUTHBRIDGE WEST BUILDING L-1, BOARDMAN, OH 44512-4300
(330) 758-7750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.023470
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064896
—
OH
Enumeration date
09/07/2011
Last updated
11/01/2013
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