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Individual

JONATHAN G CRAWFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
512 N YOUNG ST, KENNEWICK, WA 99336-7806
(509) 783-7600
(509) 783-0774
Mailing address
512 N YOUNG ST, KENNEWICK, WA 99336-7806
(509) 783-7600
(509) 783-0774

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6459
WA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
6459
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5017660
WA
Enumeration date
07/10/2006
Last updated
11/25/2014
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