Individual
DR. GARY LYLE CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
777 N 500 W, PROVO, UT 84601-1541
(801) 375-4707
Mailing address
79 N PALISADES DR, OREM, UT 84097-8218
(801) 224-5873
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
145474-9924
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18381
IHC
—
Enumeration date
10/23/2006
Last updated
06/23/2022
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