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General NPI Number Information
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NPI Number | 1720193303
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Entity Type | Individual
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Provider Name | RALPH A. CREVOISIER DDS MSD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 8110 WINDWAY DR
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City | WINDCREST
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State | TX
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Zip | 78239-2433
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Country | US
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Telephone | 210-653-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 14107 COUNTRY VALE
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City | SAN ANTONIO
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State | TX
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Zip | 78216-2354
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Country | US
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Telephone | 210-464-4678
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Fax | 210-495-4411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7663
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License Number State | TX
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