Individual
DR. JEFFREY ALLEN CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
40 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
(802) 862-7185
(802) 658-8036
Mailing address
74 MAPLE RDG RD, UNDERHILL, VT 05489-9227
(802) 899-2022
(802) 658-8036
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
615
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001847
—
VT
Enumeration date
06/24/2006
Last updated
07/08/2007
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