Crawford, Derrick Myron

Crawford, Derrick Myron is an sole proprietor health care provider with primary practice located at 505 S Mountain View Rd , Moscow ID 83843-9205. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Crawford, Derrick Myron can be contacted via phone (208) 882-6360.

Contact Information

Primary practice address
505 S Mountain View Rd Moscow ID 83843-9205
Phone: (208) 882-6360
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DE61157527 Washington
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D-5265 Idaho

Profile Details

NPI number 1497323976
LBN Legal business name Crawford, Derrick Myron
Credentials DDS, MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2021
Last updated Jun 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers