Provider Demographics
NPI:1972913176
Name:SPRING, CRYSTAL (RDH)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:SPRING
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 GREY WOLF TRL
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7677
Mailing Address - Country:US
Mailing Address - Phone:406-581-5293
Mailing Address - Fax:406-763-4637
Practice Address - Street 1:105 GREY WOLF TRL
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7677
Practice Address - Country:US
Practice Address - Phone:406-581-5293
Practice Address - Fax:406-763-4637
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1008124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist