Healthcare Provider Details

I. General information

NPI: 1194577551
Provider Name (Legal Business Name): REED CROWLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 RIVERSIDE AVE
SOMERSET MA
02726-2865
US

IV. Provider business mailing address

1421 RIVERSIDE AVE
SOMERSET MA
02726-2865
US

V. Phone/Fax

Practice location:
  • Phone: 508-673-3336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001251
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: