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General NPI Number Information
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NPI Number | 1104197714
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Entity Type | Organization
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Legal Business Name | RICHARD A. CRINZI, DDS, MS, PS
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 15955 NE 85TH ST SUITE #104
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City | REDMOND
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State | WA
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Zip | 98052-3550
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Country | US
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Telephone | 425-881-3255
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Fax | 425-885-1366
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Provider Business Mailing Address
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Address Line | 15955 NE 85TH ST SUITE 104
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City | REDMOND
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State | WA
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Zip | 98052-3550
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Country | US
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Telephone | 425-881-3255
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Fax | 425-885-1366
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD ALEX CRINZI
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Credential | DDS
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Telephone | 425-881-3255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 4194
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License Number State | WA
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