Provider Demographics
NPI:1063651081
Name:FLEMING-SMITH, CRYSTAL ROSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:ROSE
Last Name:FLEMING-SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CRYSTAL
Other - Middle Name:ROSE
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1744 FRY RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5801
Mailing Address - Country:US
Mailing Address - Phone:281-492-8900
Mailing Address - Fax:
Practice Address - Street 1:1744 FRY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5801
Practice Address - Country:US
Practice Address - Phone:281-492-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-14
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX243081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice