Healthcare Provider Details

I. General information

NPI: 1114854205
Provider Name (Legal Business Name): CRANFORD FAMILY DENTISTRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 CYPRESS ST
WEST MONROE LA
71291-7314
US

IV. Provider business mailing address

3626 CYPRESS ST
WEST MONROE LA
71291-7314
US

V. Phone/Fax

Practice location:
  • Phone: 318-396-9667
  • Fax: 318-396-9616
Mailing address:
  • Phone: 318-396-9667
  • Fax: 318-396-9616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. RUSSELL WAYNE CRANFORD
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 318-396-9667