Provider Demographics
NPI:1437666971
Name:CROWNSNOW / IMPLANTSTODAY LLC
Entity Type:Organization
Organization Name:CROWNSNOW / IMPLANTSTODAY LLC
Other - Org Name:CROWNSNOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:EIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-540-7262
Mailing Address - Street 1:126 W WISCONSIN AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:126 W WISCONSIN AVE STE 2
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3012
Practice Address - Country:US
Practice Address - Phone:920-558-4172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental