Provider Demographics
NPI:1497766844
Name:S. JEFFREY CREWS, DMD, PC
Entity Type:Organization
Organization Name:S. JEFFREY CREWS, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:706-291-2901
Mailing Address - Street 1:317 REDMOND RD NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1539
Mailing Address - Country:US
Mailing Address - Phone:706-291-2901
Mailing Address - Fax:706-291-7023
Practice Address - Street 1:317 REDMOND RD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1539
Practice Address - Country:US
Practice Address - Phone:706-291-2901
Practice Address - Fax:706-291-7023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN008939261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental