Healthcare Provider Details

I. General information

NPI: 1831003839
Provider Name (Legal Business Name): CRAWFORD LEISHMAN DENTAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 E 440 N STE B
VINEYARD UT
84059-8142
US

IV. Provider business mailing address

747 E 440 N STE B
VINEYARD UT
84059-8142
US

V. Phone/Fax

Practice location:
  • Phone: 801-225-5888
  • Fax: 385-225-9345
Mailing address:
  • Phone: 801-225-5888
  • Fax: 385-225-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: RICHARD S LEISHMAN
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 801-225-5888