Provider Demographics
NPI:1811263874
Name:WILLIAM D. CRANFORD, JR., DMD
Entity type:Organization
Organization Name:WILLIAM D. CRANFORD, JR., DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRANFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-324-7670
Mailing Address - Street 1:1721 EBENEZER RD.
Mailing Address - Street 2:SUITE 135
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1119
Mailing Address - Country:US
Mailing Address - Phone:803-324-7670
Mailing Address - Fax:803-324-5748
Practice Address - Street 1:1721 EBENEZER RD.
Practice Address - Street 2:SUITE 135
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1119
Practice Address - Country:US
Practice Address - Phone:803-324-7670
Practice Address - Fax:803-324-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZZ2569Medicaid