MEDICARE: DR. JEREMY CHRISTOPHER CROW DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS037434	PA
2	1223G0001X	General Practice Dentistry	30022237	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578600714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEREMY CHRISTOPHER CROW DDS

Provider Business Mailing Address
First Line	:	301 S HILLS VLG
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-1400
Country	:	US
Telephone Number	:	412-835-4966
Fax Number	:	412-835-2466

Provider Business Practice Location Address
First Line	:	301 S HILLS VLG
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-1400
Country	:	US
Telephone Number	:	412-835-4966
Fax Number	:	412-835-2466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	01/09/2009

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