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General NPI Number Information
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NPI Number | 1235552407
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Entity Type | Organization
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Legal Business Name | BRIAN C CRAWFORD AND PAOLO A POIDMORE, A DENTAL CORPORATION
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 4408 ELVERTA RD STE 200
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City | ANTELOPE
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State | CA
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Zip | 95843-6723
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Country | US
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Telephone | 916-276-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 3075 BEACON BLVD
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-3462
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Country | US
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Telephone | 916-259-9255
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN C CRAWFORD
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Credential | DMD
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Telephone | 916-276-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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