Provider Demographics
NPI:1780705806
Name:CROWE, DENNIS R (OD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:R
Last Name:CROWE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:606 GOLDENROD WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4156
Mailing Address - Country:US
Mailing Address - Phone:912-510-9200
Mailing Address - Fax:912-510-9202
Practice Address - Street 1:6585 HIGHWAY 40 EAST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4156
Practice Address - Country:US
Practice Address - Phone:912-510-9200
Practice Address - Fax:912-510-9202
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001834152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist