Provider Demographics
NPI:1578615969
Name:AIKEN DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:AIKEN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-648-8319
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29802-0678
Mailing Address - Country:US
Mailing Address - Phone:803-648-8319
Mailing Address - Fax:803-643-0625
Practice Address - Street 1:117 TRAFALGAR ST SW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3760
Practice Address - Country:US
Practice Address - Phone:803-648-8319
Practice Address - Fax:803-643-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty