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Individual
DR. GORDON G CROFT
Active
Individual
DR. GORDON G CROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1518
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000789200
—
ID
01
—
462879
UNITED CONCORDIA
ID
01
—
6C396
BLUE CROSS
ID
Enumeration date
02/26/2008
Last updated
04/23/2018
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