Provider Demographics
NPI:1659389567
Name:CROUT, DANNY KEITH (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:KEITH
Last Name:CROUT
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:233 E BLACKSTOCK RD
Mailing Address - Street 2:SUITE D DANNY K CROUT DMD MS
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-2652
Mailing Address - Country:US
Mailing Address - Phone:864-576-3678
Mailing Address - Fax:864-576-3181
Practice Address - Street 1:233 E BLACKSTOCK RD
Practice Address - Street 2:SUITE D DANNY K CROUT DMD MS
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2652
Practice Address - Country:US
Practice Address - Phone:864-576-3678
Practice Address - Fax:864-576-3181
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1792122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U74327Medicare UPIN