Provider Demographics
NPI:1396867164
Name:CRUMPTON, AMANDA S (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:S
Last Name:CRUMPTON
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 1:36 ROPER CORNERS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4833
Mailing Address - Country:US
Mailing Address - Phone:864-297-8071
Mailing Address - Fax:864-297-8073
Practice Address - Street 1:36 ROPER CORNERS CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4833
Practice Address - Country:US
Practice Address - Phone:864-297-8071
Practice Address - Fax:864-297-8073
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice