NPI | 1811283450 |
---|---|
Other Name | KRISTEN RENEE CRAWFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 29356) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2014031509) |
1223G0001X Dentist, General Practice (Licence: LA 6244) | |
Enumeration Date | 2011-06-22 |
Last Update Date | 2022-01-10 |