Provider Demographics
NPI:1174377485
Name:CRAWFORD, LAURA (RDH, PHDHP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RDH, PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 ORIOLE CIR N
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-8827
Mailing Address - Country:US
Mailing Address - Phone:504-579-4608
Mailing Address - Fax:
Practice Address - Street 1:1031 ORIOLE CIR N
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-8827
Practice Address - Country:US
Practice Address - Phone:504-579-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPADH071099124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist