Provider Demographics
NPI:1275776239
Name:CROWE, SHARON LOUISE (RDH,BSDH, MS)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LOUISE
Last Name:CROWE
Suffix:
Gender:F
Credentials:RDH,BSDH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2264
Mailing Address - Country:US
Mailing Address - Phone:920-740-9565
Mailing Address - Fax:
Practice Address - Street 1:1814 NORTH APPLETON ROAD
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952
Practice Address - Country:US
Practice Address - Phone:920-731-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4181-016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist