Provider Demographics
NPI:1629180963
Name:CROWE, LAURA SUZANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:SUZANNE
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 1:19000 COX AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4155
Mailing Address - Country:US
Mailing Address - Phone:408-257-5300
Mailing Address - Fax:
Practice Address - Street 1:19000 COX AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4155
Practice Address - Country:US
Practice Address - Phone:408-257-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice