Provider Demographics
NPI:1588067441
Name:STINSON, CRYSTAL PEARL (DDS)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:PEARL
Last Name:STINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8224 PARK LN STE 125
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-6020
Mailing Address - Country:US
Mailing Address - Phone:832-428-5882
Mailing Address - Fax:
Practice Address - Street 1:8224 PARK LN STE 125
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-6020
Practice Address - Country:US
Practice Address - Phone:832-428-5882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30140122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist