# CRAWFORDSVILLE ORAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053617746
- **Authorized official:** BRETT HENRIKSON DDS (OWNER)
- **Authorized official phone:** (765) 807-0230

## Contact information

- **Practice address:** 408 W MARKET ST, CRAWFORDSVILLE, IN 47933-1600
- **Practice address phone:** (765) 807-0230
- **Mailing address:** 408 W MARKET ST, CRAWFORDSVILLE, IN 47933-1600
- **Mailing address phone:** (765) 807-0230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 1201055A | IN | Yes |

## Other

- **Enumeration date:** 01/28/2011
- **Last updated:** 01/28/2011