Provider Demographics
NPI:1346708484
Name:CROWN DENTISTRY
Entity Type:Organization
Organization Name:CROWN DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-460-5033
Mailing Address - Street 1:1006 N BOWEN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2868
Mailing Address - Country:US
Mailing Address - Phone:817-460-5033
Mailing Address - Fax:817-795-5213
Practice Address - Street 1:1006 N BOWEN RD STE 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2868
Practice Address - Country:US
Practice Address - Phone:817-460-5033
Practice Address - Fax:817-795-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental