Doctor Name: | JERRY L CRAWFORD |
NPI Number: | 1003928698 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S., M.S.D. |
License Number: | DN006726 |
Business Practice Address: | 705 Oglethorpe Ave Athens, GA - 306062242 |
Business Phone Number: | 7065491220 |
Business Fax Number: | |
Mailing Address: | 705 Oglethorpe Ave, ATHENS |
State: | GA |
Postal Code: | 306062242 |
Phone Number: | 7065491220 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DN006726 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |