| Crawford Dental Group | |
|
5060 Logan Ave San Diego CA 92113 | |
| (619) 262-0706 | |
| (619) 262-4207 |
| Full Name | Crawford Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 5060 Logan Ave, San Diego, California |
| Authorized Official Name and Position | Michael D Crawford (PRESIDENT) |
| Authorized Official Contact | 6192620706 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crawford Dental Group Po Box 13646 5060 Logan Ave San Diego CA 92113 Ph: (619) 262-0706 | Crawford Dental Group 5060 Logan Ave San Diego CA 92113 Ph: (619) 262-0706 |
| NPI Number | 1851454870 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 09/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851454870 | NPI | - | NPPES |
| G9224701 | Medicaid | CA | |
| B2381501 | Other | CA | DELTA DENTAL HEALTHY FAMI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 23815 (California) | Primary |
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