Provider Demographics
NPI:1326299215
Name:MICHAEL L. CROWTON DDS
Entity Type:Organization
Organization Name:MICHAEL L. CROWTON DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CROWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-479-7870
Mailing Address - Street 1:448 E 5350 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-6931
Mailing Address - Country:US
Mailing Address - Phone:801-479-7870
Mailing Address - Fax:801-479-0606
Practice Address - Street 1:448 E 5350 S
Practice Address - Street 2:SUITE A
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6931
Practice Address - Country:US
Practice Address - Phone:801-479-7870
Practice Address - Fax:801-479-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49375361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty