Provider Demographics
NPI:1790861888
Name:CRAIN, GERALD KYLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:KYLE
Last Name:CRAIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6837 COIT RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5417
Mailing Address - Country:US
Mailing Address - Phone:972-618-5050
Mailing Address - Fax:972-618-5327
Practice Address - Street 1:6837 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5417
Practice Address - Country:US
Practice Address - Phone:972-618-5050
Practice Address - Fax:972-618-5327
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics