Individual
DR. LARRY A CRISAFULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1121 W MICHIGAN STREET, DS307B, INDIANAPOLIS, IN 46202-5186
(317) 278-3632
(317) 274-2603
Mailing address
1121 W MICHIGAN STREET, DS307B, INDIANAPOLIS, IN 46202-5186
(202) 332-2291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012038A
IN
Other
Enumeration date
02/20/2009
Last updated
11/15/2016
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