Provider Demographics
NPI:1912962598
Name:CROW, CARIS (DDS, MAGD)
Entity Type:Individual
Prefix:
First Name:CARIS
Middle Name:
Last Name:CROW
Suffix:
Gender:M
Credentials:DDS, MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 E FLAMINGO RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5223
Mailing Address - Country:US
Mailing Address - Phone:702-737-6080
Mailing Address - Fax:702-699-9085
Practice Address - Street 1:2880 E FLAMINGO RD
Practice Address - Street 2:SUITE H
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5223
Practice Address - Country:US
Practice Address - Phone:702-737-6080
Practice Address - Fax:702-699-9085
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1093122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist