Crawford, Richard W
Crawford, Richard W is an individual health care provider with primary practice located at 440 Western Ave , South Portland ME 04106. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Crawford, Richard W can be contacted via phone (207) 774-2611.Contact Information
Primary practice address
440 Western Ave
South Portland ME 04106
Phone: (207) 774-2611
Fax: (207) 774-2613
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 3428 | Maine |
Profile Details
| NPI number | 1174629794 |
|---|---|
| LBN Legal business name | Crawford, Richard W |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Jun 12th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174629794 | NPPES |
| Maine | MEDICAID | 304020099 |
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