Organization
CRAWFORD IMPLANT & LASER PERIODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADALINE CRAWFORD (ACCOUNTANT)
(727) 542-3096
Entity
Organization
Contact information
Practice address
5601 1ST AVE S, ST PETERSBURG, FL 33707-1703
(727) 343-3005
Mailing address
5601 1ST AVE S, ST PETERSBURG, FL 33707-1703
(727) 343-3005
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386317899
DMD
FL
01
—
1669643532
DMD
FL
Enumeration date
02/08/2024
Last updated
02/09/2024
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