Provider Demographics
NPI:1477849289
Name:COLTON J CRANE DMD PC
Entity Type:Organization
Organization Name:COLTON J CRANE DMD PC
Other - Org Name:RENDEZVOUS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLTON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-856-2778
Mailing Address - Street 1:831 W SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-2353
Mailing Address - Country:US
Mailing Address - Phone:307-856-2778
Mailing Address - Fax:307-856-6572
Practice Address - Street 1:831 W SUNSET DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2353
Practice Address - Country:US
Practice Address - Phone:307-856-2778
Practice Address - Fax:307-856-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental