Organization
ST.ELMO W. CRAWFORD D.D.S.P.C.
Active
Other names
Connecticut Avenue Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ST.ELMO WALLACE CRAWFORD JR. D.D.S. (PRESIDENT)
(202) 399-2244
Entity
Organization
Contact information
Practice address
1922 BENNING RD NE, WASHINGTON, DC 20002-4724
(202) 399-2244
(202) 388-1115
Mailing address
1922 BENNING RD NE, WASHINGTON, DC 20002-4724
(202) 399-2244
(202) 399-7800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN3272
DC
1223P0221X
Pediatric Dentistry
DEN3272
DC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DEN3272
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016851500
—
DC
05
—
035217400
—
DC
Enumeration date
05/21/2007
Last updated
12/13/2012
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