MEDICARE: SARAH KATHRYN CRUMP DMD

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
1	1223G0001X	General Practice Dentistry	13690	NC

General Provider Information

NPI Number	:	1639856800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH KATHRYN CRUMP DMD

Provider Business Mailing Address
First Line	:	107 E STARGRASS CIR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-6394
Country	:	US
Telephone Number	:	919-357-3852
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 PARKWAY DR STE A
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9429
Country	:	US
Telephone Number	:	919-230-0305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	02/19/2025

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