Crawford, Brian Robert

Crawford, Brian Robert is an individual health care provider with primary practice located at 465 Memorial Dr. , Pocatello ID 83209-8088. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Crawford, Brian Robert can be contacted via phone (208) 282-5275.

Contact Information

Primary practice address
465 Memorial Dr. Pocatello ID 83209-8088
Phone: (208) 282-5275
Fax: (208) 282-4950
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D3734 Idaho
Dental Providers / General Practice 1223G0001X Illinois

Profile Details

NPI number 1730304437
LBN Legal business name Crawford, Brian Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2007
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730304437 NPPES
Idaho MEDICAID 8068165

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