Healthcare Provider Details

I. General information

NPI: 1487705208
Provider Name (Legal Business Name): JODY L. CROWL, D.D.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W MAIN ST
LAUREL MT
59044-3106
US

IV. Provider business mailing address

PO BOX 338
LAUREL MT
59044-0338
US

V. Phone/Fax

Practice location:
  • Phone: 406-628-8741
  • Fax: 406-628-8741
Mailing address:
  • Phone: 406-628-8741
  • Fax: 406-628-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1965
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JODY LYNN CROWL
Title or Position: OWNER
Credential: DDS
Phone: 406-628-8741