Healthcare Provider Details

I. General information

NPI: 1376822387
Provider Name (Legal Business Name): CRYSTAL LYNETTE WILLIAMS MAYNARD DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 KING GEORGE BLVD STE B
SAVANNAH GA
31419-8329
US

IV. Provider business mailing address

821 KING GEORGE BLVD STE B
SAVANNAH GA
31419-8329
US

V. Phone/Fax

Practice location:
  • Phone: 912-226-2600
  • Fax:
Mailing address:
  • Phone: 912-226-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN015069
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: