Provider Demographics
NPI:1295739720
Name:CRICHTON, DAVID DREWRY (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DREWRY
Last Name:CRICHTON
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 1:1625 MEDICAL CENTER PT
Mailing Address - Street 2:STE 260
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8721
Mailing Address - Country:US
Mailing Address - Phone:719-473-2650
Mailing Address - Fax:719-473-2508
Practice Address - Street 1:1625 MEDICAL CENTER PT
Practice Address - Street 2:STE 260
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8721
Practice Address - Country:US
Practice Address - Phone:719-473-2650
Practice Address - Fax:719-473-2508
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1051871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery