Provider Demographics
NPI:1932309077
Name:CRAWFORD, JOHN BURNS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BURNS
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:412 CERNON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4549
Mailing Address - Country:US
Mailing Address - Phone:707-447-0900
Mailing Address - Fax:707-447-0956
Practice Address - Street 1:412 CERNON ST
Practice Address - Street 2:SUITE B
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4549
Practice Address - Country:US
Practice Address - Phone:707-447-0900
Practice Address - Fax:707-447-0956
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA257911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics