Provider Demographics
NPI:1407881113
Name:CROWE, CORRIE JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORRIE
Middle Name:JEAN
Last Name:CROWE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1617
Mailing Address - Country:US
Mailing Address - Phone:215-898-8965
Mailing Address - Fax:215-573-4090
Practice Address - Street 1:240 S 40TH ST STE 916
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-6030
Practice Address - Country:US
Practice Address - Phone:215-898-8965
Practice Address - Fax:215-573-4090
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0376761223G0001X
NJDI023680001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice