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Contact Information

JODI L CRANDALL, DHAT
1001 S KNIK GOOSE BAY RD
WASILLA, AK99654-8083
 Phone: 190-729-7690
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Therapist

125J00000X
Indicates primary specialty

NPI Profile & details for JODI L CRANDALL · (Female)

NPI Number 1679270748
Status Active
Credentials DHAT
Entity Individual
Enumeration date 02/09/2023
Last updated 02/09/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 23-173-DHAT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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