Provider Demographics
NPI:1801779665
Name:CRANNAGE, ROBERT PETER III (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PETER
Last Name:CRANNAGE
Suffix:III
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 1:2800 COORS BLVD NW STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1204
Mailing Address - Country:US
Mailing Address - Phone:505-352-1166
Mailing Address - Fax:505-352-2805
Practice Address - Street 1:2800 COORS BLVD NW STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1204
Practice Address - Country:US
Practice Address - Phone:505-352-1166
Practice Address - Fax:505-352-2805
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDB-2025-01431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice