| Doctor Name: | DOUGLAS ARTHUR CRUMB |
| NPI Number: | 1154506889 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 7 |
| Business Practice Address: | 6420 Hwy 93 S. Lakeside, MT - 59922 |
| Business Phone Number: | 4068573711 |
| Business Fax Number: | 4068573712 |
| Mailing Address: | 6420 Hwy 93 South, Po. Box 792 LAKESIDE |
| State: | MT |
| Postal Code: | 59922 |
| Phone Number: | 4068573711 |
| Fax Number: | 4068573712 |
| NPI Enumeration Date: | 12/31/2007 |
| NPI Last Update Date: | 12/31/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | 7 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |