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NPI Code Detail

MEDICARE: DR. CRAIG HANNIE CRAWFORD DDS

MEDICARE: DR. CRAIG HANNIE CRAWFORD DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry4948LA

General Provider Information

NPI Number : 1386771632
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG HANNIE CRAWFORD DDS
Provider Business Mailing Address
First Line : 701 W COLLEGE ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-1523
Country : US
Telephone Number : 337-478-7590
Fax Number : 337-478-1804
Provider Business Practice Location Address
First Line : 701 W COLLEGE ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-1523
Country : US
Telephone Number : 337-478-7590
Fax Number : 337-478-1804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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