Provider Demographics
NPI:1013560242
Name:CROWE, CAMERON FRANCIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:FRANCIS
Last Name:CROWE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN AVE STE 1329
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3722
Mailing Address - Country:US
Mailing Address - Phone:312-782-2844
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 1329
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3722
Practice Address - Country:US
Practice Address - Phone:312-782-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist