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NPI Code Detail

MEDICARE: DR. DONALD CRAYDEN DENNARD D.D.S.

MEDICARE: DR. DONALD CRAYDEN DENNARD D.D.S.
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
11223G0001XGeneral Practice Dentistry11642TX

General Provider Information

NPI Number : 1235140096
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD CRAYDEN DENNARD D.D.S.
Provider Business Mailing Address
First Line : 4040 AVENUE F
Second Line :
City : BAY CITY
State : TX
Zip : 77414-7612
Country : US
Telephone Number : 979-245-4746
Fax Number : 979-244-4746
Provider Business Practice Location Address
First Line : 4040 AVENUE F
Second Line :
City : BAY CITY
State : TX
Zip : 77414-7612
Country : US
Telephone Number : 979-245-4747
Fax Number : 979-244-4746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 11/30/2016

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