Provider Demographics
NPI:1477343630
Name:CRANFORD, ETHAN (DDS)
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:
Last Name:CRANFORD
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 1:3626 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7314
Mailing Address - Country:US
Mailing Address - Phone:318-396-9667
Mailing Address - Fax:318-396-9616
Practice Address - Street 1:3626 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7314
Practice Address - Country:US
Practice Address - Phone:318-396-9667
Practice Address - Fax:318-396-9619
Is Sole Proprietor?:No
Enumeration Date:2025-05-10
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA76681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice