Individual
DR. JOHN GEORGE CRAWFORD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
401 WALL ST UNIT D, VALPARAISO, IN 46383-2585
(219) 286-6228
(219) 217-3673
Mailing address
37352 S MACKS RD, CUSTER PARK, IL 60481-8426
(708) 790-9788
(708) 524-0815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013818A
IN
1223P0221X
Pediatric Dentistry
021.000832
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021.000939
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019.000939
DENTAL LICENSE
IL
01
—
021.000832
SPECIALIST, PEDODONTICS
IL
01
—
021.000939
SPECIALIST, ORTHODONTICS
IL
01
—
12013818A
DENTAL LICENSE
IN
Enumeration date
04/03/2007
Last updated
12/02/2022
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