Individual
PRECIOUS LAVERNE CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3604 JOHN CARROL DR, DECATUR, GA 30034-5600
(404) 218-9200
(000) 000-0000
Mailing address
3604 JOHN CARROL DR, DECATUR, GA 30034-5600
(404) 218-9200
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN010948
GA
1223P0300X
Periodontics
DN010948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582398245
TAX ID
GA
Enumeration date
11/28/2006
Last updated
12/21/2022
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