| Raymond A. Crisio, D.m.d. Pc | |
|
305 Broad Evansville IL 62242-0019 | |
| (618) 853-2215 | |
| (618) 853-2595 |
| Full Name | Raymond A. Crisio, D.m.d. Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 305 Broad, Evansville, Illinois |
| Authorized Official Name and Position | Raymond A. Crisio (OWNER) |
| Authorized Official Contact | 6188532215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raymond A. Crisio, D.m.d. Pc 4933 Benchmark Centre Dr Swansea IL 62226-8927 Ph: (618) 632-4003 | Raymond A. Crisio, D.m.d. Pc 305 Broad Evansville IL 62242-0019 Ph: (618) 853-2215 |
| NPI Number | 1104236769 |
|---|---|
| Provider Enumeration Date | 05/05/2014 |
| Last Update Date | 05/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104236769 | NPI | - | NPPES |
| 113052 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Raymond A. Crisio Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Broad, Evansville, IL 62242 Phone: 618-853-2215 Fax: 618-853-2595 |