Provider Demographics
NPI:1164528931
Name:CRAWFORD, STEPHEN LEIGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LEIGH
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 BETHLEHEM PIKE
Mailing Address - Street 2:STE 102
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-1919
Mailing Address - Country:US
Mailing Address - Phone:215-233-4141
Mailing Address - Fax:215-233-4141
Practice Address - Street 1:1107 BETHLEHEM PIKE
Practice Address - Street 2:STE 102
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1919
Practice Address - Country:US
Practice Address - Phone:215-233-4141
Practice Address - Fax:215-233-4141
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA21665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist