Provider Demographics
NPI:1386646412
Name:CRAWFORD, JERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1279
Mailing Address - Country:US
Mailing Address - Phone:303-796-7400
Mailing Address - Fax:303-796-7956
Practice Address - Street 1:7400 E ARAPAHOE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1279
Practice Address - Country:US
Practice Address - Phone:303-796-7400
Practice Address - Fax:303-796-7956
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice