| Charles H. Crawford, Jr Dmd | |
|
1236 Ebenezer Rd Suite 110 Rock Hill SC 29732-2300 | |
| (803) 324-7540 | |
| (803) 324-4128 |
| Full Name | Charles H. Crawford, Jr Dmd |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1236 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Charles Harmon Crawford (PRESIDENT) |
| Authorized Official Contact | 8033247540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles H. Crawford, Jr Dmd 1236 Ebenezer Rd Suite 110 Rock Hill SC 29732-2300 Ph: (803) 324-7540 | Charles H. Crawford, Jr Dmd 1236 Ebenezer Rd Suite 110 Rock Hill SC 29732-2300 Ph: (803) 324-7540 |
| NPI Number | 1083612170 |
|---|---|
| Provider Enumeration Date | 07/12/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083612170 | NPI | - | NPPES |
| ZA-9869 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (South Carolina) | Primary |
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