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Individual

STEVEN S CRUMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
900 N LIBERTY ST STE 202, BOISE, ID 83704-8707
(208) 376-7413
(208) 376-7428
Mailing address
900 N LIBERTY ST STE 202, BOISE, ID 83704-8707
(208) 376-7413
(208) 376-7428

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4161
ID
1223G0001X
General Practice Dentistry
DE00010582
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5054432
WA
Enumeration date
03/31/2008
Last updated
07/01/2008
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