Provider Demographics
NPI:1457533325
Name:JAMES M. CROUSE, DDS, PA
Entity Type:Organization
Organization Name:JAMES M. CROUSE, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:410-749-2933
Mailing Address - Street 1:1413 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7130
Mailing Address - Country:US
Mailing Address - Phone:410-749-2933
Mailing Address - Fax:410-749-0239
Practice Address - Street 1:1413 WESLEY DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7130
Practice Address - Country:US
Practice Address - Phone:410-749-2933
Practice Address - Fax:410-749-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD89441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty