Provider Demographics
NPI:1346624566
Name:CROW, VICTORIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:CROW
Suffix:
Gender:F
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:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:PRIMOS SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-0530
Mailing Address - Country:US
Mailing Address - Phone:610-400-8593
Mailing Address - Fax:
Practice Address - Street 1:259 METRO DR
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976
Practice Address - Country:US
Practice Address - Phone:484-406-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0404001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice