Provider Demographics
NPI:1952032120
Name:CRNALIC, LINDSEY ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:ANN
Last Name:CRNALIC
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:CARMICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8308 ROUND LEAF LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-8694
Mailing Address - Country:US
Mailing Address - Phone:727-348-0830
Mailing Address - Fax:
Practice Address - Street 1:13612 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9638
Practice Address - Country:US
Practice Address - Phone:813-510-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL271151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice