| Brian T. Crosby Dmd Pa | |
|
2154 Harden Blvd Lakeland FL 33803-5917 | |
| (863) 683-8127 | |
| (863) 683-4107 |
| Full Name | Brian T. Crosby Dmd Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2154 Harden Blvd, Lakeland, Florida |
| Authorized Official Name and Position | Brian Tate Crosby (PRESIDENT) |
| Authorized Official Contact | 8636838127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian T. Crosby Dmd Pa 2154 Harden Blvd Lakeland FL 33803-5917 Ph: (863) 683-8127 | Brian T. Crosby Dmd Pa 2154 Harden Blvd Lakeland FL 33803-5917 Ph: (863) 683-8127 |
| NPI Number | 1497818629 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 11/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497818629 | NPI | - | NPPES |
| 995665 | Other | FL | COMPDENT |
| 57057 | Other | FL | UNITED CONCORDIA |
| 64967 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN0013748 (Florida) | Primary |
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