Healthcare Provider Details

I. General information

NPI: 1205087145
Provider Name (Legal Business Name): LINDA ANN CRAWFORD DDS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 DOUGLAS AVE SUITE 650
DALLAS TX
75225-5923
US

IV. Provider business mailing address

8222 DOUGLAS AVE SUITE 650
DALLAS TX
75225-5923
US

V. Phone/Fax

Practice location:
  • Phone: 214-361-6644
  • Fax: 214-594-0014
Mailing address:
  • Phone: 214-361-6644
  • Fax: 214-594-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number16695
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: