Individual
JODI L CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DHAT
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(190) 729-7690
Mailing address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(190) 729-7690
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
23-173-DHAT
AK
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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