Individual
TANNER LAYNE CRANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7625 S MERIDIAN ST, INDIANAPOLIS, IN 46217-4257
(317) 881-8271
Mailing address
3840 CHURCHMAN WOODS BLVD, INDIANAPOLIS, IN 46203-6094
(260) 515-3217
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013136A
IN
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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