Individual
KEITH SCOTT CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3850 HOLCOMB BRIDGE ROAD, SUITE 230, NORCROSS, GA 30092
(770) 447-5311
(770) 417-3500
Mailing address
2711 LOVEJOY CIRCLE, DULUTH, GA 30097
(678) 474-0622
(770) 417-3500
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9310
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00217797B
—
GA
Enumeration date
11/16/2006
Last updated
07/08/2007
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