Provider Demographics
NPI:1972531739
Name:CRAWFORD, ALAN W (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:W
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 1:916 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5921
Mailing Address - Country:US
Mailing Address - Phone:870-239-3414
Mailing Address - Fax:870-239-3244
Practice Address - Street 1:916 W COURT ST
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5921
Practice Address - Country:US
Practice Address - Phone:870-239-3414
Practice Address - Fax:870-239-3244
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2349122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR833635OtherUNITED CONCORDIA
AR58000OtherBLUE CROSS BLUE SHIELD
AR2349OtherDELTA DENTAL