Provider Demographics
NPI:1861719270
Name:CRAWFORD, SHARON L (RDH, BSDH)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:L
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 GLEN CREEK RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:470 GLEN CREEK RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3060
Practice Address - Country:US
Practice Address - Phone:503-581-1142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4520124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist