Provider Demographics
NPI:1447300850
Name:CRUMPTON, REID RICHMOND (DDS)
Entity type:Individual
Prefix:DR
First Name:REID
Middle Name:RICHMOND
Last Name:CRUMPTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E EMORY RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4014
Mailing Address - Country:US
Mailing Address - Phone:865-938-1230
Mailing Address - Fax:865-938-1239
Practice Address - Street 1:123 E EMORY RD
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4014
Practice Address - Country:US
Practice Address - Phone:865-938-1230
Practice Address - Fax:865-938-1239
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 39451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice