Provider Demographics
NPI:1508945395
Name:CRIPPEN, STEVEN CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CRAIG
Last Name:CRIPPEN
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 1:808 NEW HIGHWAY 68
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SWEETWATER
Mailing Address - State:TN
Mailing Address - Zip Code:37874-1904
Mailing Address - Country:US
Mailing Address - Phone:423-337-6141
Mailing Address - Fax:423-337-6142
Practice Address - Street 1:808 NEW HIGHWAY 68
Practice Address - Street 2:SUITE 2
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874-1904
Practice Address - Country:US
Practice Address - Phone:423-337-6141
Practice Address - Fax:423-337-6142
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-29351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice