Provider Demographics
NPI:1871502609
Name:CROZIER, DAVID JACK (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JACK
Last Name:CROZIER
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 1:690 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9501
Mailing Address - Country:US
Mailing Address - Phone:724-728-3991
Mailing Address - Fax:
Practice Address - Street 1:690 STATE AVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9501
Practice Address - Country:US
Practice Address - Phone:724-728-3991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 18543L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics