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NPI Code Detail

MEDICARE: DR. GERALD KYLE CRAIN D.D.S.

MEDICARE: DR. GERALD KYLE CRAIN 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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry15852TX

General Provider Information

NPI Number : 1790861888
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD KYLE CRAIN D.D.S.
Provider Business Mailing Address
First Line : 6837 COIT RD
Second Line :
City : PLANO
State : TX
Zip : 75024-5417
Country : US
Telephone Number : 972-618-5050
Fax Number : 972-618-5327
Provider Business Practice Location Address
First Line : 6837 COIT RD
Second Line :
City : PLANO
State : TX
Zip : 75024-5417
Country : US
Telephone Number : 972-618-5050
Fax Number : 972-618-5327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 07/08/2007

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