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NPI Code Detail

MEDICARE: DR. ROBERT WADE CRABTREE III DDS

MEDICARE: DR. ROBERT WADE CRABTREE III DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist36699NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053397307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT WADE CRABTREE III DDS
Provider Business Mailing Address
First Line : 1152 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14209-2331
Country : US
Telephone Number : 716-886-1000
Fax Number : 716-886-1028
Provider Business Practice Location Address
First Line : 1152 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14209-2331
Country : US
Telephone Number : 716-886-1000
Fax Number : 716-886-1028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 07/03/2012

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