Individual
DEONTAY CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2809 MANSION RD STE D, SPRINGFIELD, IL 62711-6811
(217) 717-4405
Mailing address
220 SAWGRASS DR APT 7, CHATHAM, IL 62629-8118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031207
IL
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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