Individual
DR. PHILLIP CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2581 DEVELOPMENT DR STE 204, BELLEVUE, WI 54311-4248
(920) 347-2640
Mailing address
2581 DEVELOPMENT DR STE 204, BELLEVUE, WI 54311-4248
(920) 347-2640
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1002021-15
WI
Other
Enumeration date
08/11/2016
Last updated
01/07/2020
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