Organization
SHERI CRAWFORD, DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERI CRAWFORD DMD (DENTIST OWNER)
(404) 578-1018
Entity
Organization
Contact information
Practice address
1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5889
(260) 471-1695
Mailing address
1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5889
(260) 471-1695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154877611
NPI TYPE 1
IN
01
—
12013723A
IN DENTAL LICENSE
IN
Enumeration date
11/02/2022
Last updated
11/02/2022
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