Provider Demographics
NPI:1457847303
Name:ANDREW J CROWSON DDS
Entity Type:Organization
Organization Name:ANDREW J CROWSON DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-939-1868
Mailing Address - Street 1:1920 N MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1948
Mailing Address - Country:US
Mailing Address - Phone:254-939-1868
Mailing Address - Fax:254-933-0402
Practice Address - Street 1:1920 N MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1948
Practice Address - Country:US
Practice Address - Phone:254-939-1868
Practice Address - Fax:254-933-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty