Provider Demographics
NPI:1558000950
Name:CRAWFORD, KRISTOPHER VINCENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:VINCENT
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 1:1213 HYDRANGEA CIR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7263
Mailing Address - Country:US
Mailing Address - Phone:912-492-9710
Mailing Address - Fax:
Practice Address - Street 1:1421 CONCORD PKWY N STE 10
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2921
Practice Address - Country:US
Practice Address - Phone:704-886-5104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC130161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice