Healthcare Provider Details
I. General information
NPI: 1851034250
Provider Name (Legal Business Name): GCCRANE DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2022
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1850 W MOUNT HOPE AVE
LANSING MI
48910-2482
US
IV. Provider business mailing address
1850 W MOUNT HOPE AVE
LANSING MI
48910-2482
US
V. Phone/Fax
- Phone: 517-482-8466
- Fax: 517-482-8628
- Phone: 517-482-8466
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GERALD
C
CRANE
Title or Position: DENTIST AND PRESIDENT OF PC
Credential: DDS
Phone: 517-482-8466