Individual
DR. JOHN ROBERT CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
7851 COOPER RD, KENOSHA, WI 53142-4181
(262) 694-5272
(262) 694-3121
Mailing address
7851 COOPER RD, KENOSHA, WI 53142-4181
(262) 694-5272
(262) 694-3121
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2969-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391554736
S-CORP
WI
Enumeration date
05/02/2007
Last updated
07/08/2007
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