Provider Demographics
NPI:1962530949
Name:CRAWFORD, J. CHRIS (DDS)
Entity type:Individual
Prefix:
First Name:J.
Middle Name:CHRIS
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4611
Mailing Address - Country:US
Mailing Address - Phone:801-225-5888
Mailing Address - Fax:801-224-1595
Practice Address - Street 1:265 W CENTER ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4611
Practice Address - Country:US
Practice Address - Phone:801-225-5888
Practice Address - Fax:801-224-1595
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1415721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice