Provider Demographics
NPI:1841213949
Name:CRAWFORD, MELVIN BRENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:BRENT
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 1:16525 BIRKDALE CMNS PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3802
Mailing Address - Country:US
Mailing Address - Phone:704-895-5850
Mailing Address - Fax:704-895-9808
Practice Address - Street 1:16525 BIRKDALE CMNS PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3802
Practice Address - Country:US
Practice Address - Phone:704-895-5850
Practice Address - Fax:704-895-9808
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice