# CHARLES H. CRAWFORD, JR DMD

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

## Provider details

- **NPI number:** 1083612170
- **Authorized official:** DR. CHARLES HARMON CRAWFORD JR. DMD (PRESIDENT)
- **Authorized official phone:** (803) 324-7540

## Contact information

- **Practice address:** 1236 EBENEZER RD, SUITE 110, ROCK HILL, SC 29732-2300
- **Practice address phone:** (803) 324-7540
- **Practice address fax:** (803) 324-4128
- **Mailing address:** 1236 EBENEZER RD, SUITE 110, ROCK HILL, SC 29732-2300
- **Mailing address phone:** (803) 324-7540
- **Mailing address fax:** (803) 324-4128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | SC | Yes |

## Other

- **Enumeration date:** 07/12/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZA-9869 | — | SC |