# J. ANDREW CRAYCROFT D.M.D. INC.

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

## Provider details

- **NPI number:** 1295011880
- **Authorized official:** JANET M. LONGEST (OFFICE MGR.)
- **Authorized official phone:** (270) 781-4997

## Contact information

- **Practice address:** 1711 ASHLEY CIR, SUITE 3, BOWLING GREEN, KY 42104-5801
- **Practice address phone:** (270) 781-4997
- **Practice address fax:** (270) 781-8557
- **Mailing address:** 1711 ASHLEY CIR, SUITE 3, BOWLING GREEN, KY 42104-5801
- **Mailing address phone:** (270) 781-4997
- **Mailing address fax:** (270) 781-8557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6137 | KY | Yes |

## Other

- **Enumeration date:** 10/26/2011
- **Last updated:** 10/26/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 21062 | MCNA DENTAL | — |
| 05 | — | 60061371 | — | KY |
| 01 | — | 60633DM | AVESIS | — |