# SHERI CRAWFORD, DMD, LLC

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

## Provider details

- **NPI number:** 1811604440
- **Authorized official:** SHERI CRAWFORD DMD (DENTIST OWNER)
- **Authorized official phone:** (404) 578-1018

## Contact information

- **Practice address:** 1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5889
- **Practice address phone:** (260) 471-1695
- **Mailing address:** 1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5889
- **Mailing address phone:** (260) 471-1695

## Taxonomy

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

## Other

- **Enumeration date:** 11/02/2022
- **Last updated:** 11/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1154877611 | NPI TYPE 1 | IN |
| 01 | — | 12013723A | IN DENTAL LICENSE | IN |