Individual
DR. CRAIG DOUGLAS CRISPIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
60 FOURTH ST., SUITE B, POINT REYES STATION, CA 94956-0550
(415) 663-1430
Mailing address
PO BOX 550, 60 FOURTH ST. SUITE B, POINT REYES STATION, CA 94956-0550
(415) 663-1430
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28530
STATE LICENSE
CA
01
—
94-2908493
FEDERAL TAX ID
—
Enumeration date
01/22/2007
Last updated
07/08/2007
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