Provider Demographics
NPI:1114169737
Name:CRICHTON, JONELLE (DMD)
Entity Type:Individual
Prefix:
First Name:JONELLE
Middle Name:
Last Name:CRICHTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 JACARANDA COUNTRY CLUB DR
Mailing Address - Street 2:#200
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2510
Mailing Address - Country:US
Mailing Address - Phone:786-252-9165
Mailing Address - Fax:
Practice Address - Street 1:100 JACARANDA COUNTRY CLUB DR
Practice Address - Street 2:#200
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2510
Practice Address - Country:US
Practice Address - Phone:786-252-9165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program