Provider Demographics
NPI:1952469702
Name:CRANFILL, THOMAS B (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:CRANFILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12907 FACTORY LN STE B
Mailing Address - Street 2:P. O. BOX 23306
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5433
Mailing Address - Country:US
Mailing Address - Phone:502-243-9200
Mailing Address - Fax:502-243-9285
Practice Address - Street 1:12907 FACTORY LN STE B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5433
Practice Address - Country:US
Practice Address - Phone:502-243-9200
Practice Address - Fax:502-243-9285
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY75901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice