Provider Demographics
NPI:1548991995
Name:CRUSEN, ABIGAIL M (DDS)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:CRUSEN
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 1:6660 MUIRHEAD RD
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-8847
Mailing Address - Country:US
Mailing Address - Phone:989-397-6418
Mailing Address - Fax:
Practice Address - Street 1:1610 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3380
Practice Address - Country:US
Practice Address - Phone:989-684-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601432122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist