Provider Demographics
NPI:1417088089
Name:CRAWFORD, TAYLOR LEE II (DMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:LEE
Last Name:CRAWFORD
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:2901 BLUE RIDGE DR W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3332
Mailing Address - Country:US
Mailing Address - Phone:251-665-4611
Mailing Address - Fax:251-661-6441
Practice Address - Street 1:4216 AURELIA ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2875
Practice Address - Country:US
Practice Address - Phone:251-661-0282
Practice Address - Fax:251-661-6441
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL48341223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics