Organization
BRIAN T. CROSBY DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN TATE CROSBY DMD (PRESIDENT)
(863) 683-8127
Entity
Organization
Contact information
Practice address
2154 HARDEN BLVD, LAKELAND, FL 33803-5917
(863) 683-8127
(863) 683-4107
Mailing address
2154 HARDEN BLVD, LAKELAND, FL 33803-5917
(863) 683-8127
(863) 683-4107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0013748
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57057
UNITED CONCORDIA
FL
01
—
64967
BCBS
FL
01
—
995665
COMPDENT
FL
Enumeration date
12/19/2006
Last updated
11/09/2009
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