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General NPI Number Information
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NPI Number | 1003133372
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Entity Type | Organization
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Legal Business Name | TIMOTHY M. CROWE DMD PC
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE SUITE 1329
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-782-2844
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Fax | 312-783-5780
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Provider Business Mailing Address
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Address Line | 30 N MICHIGAN AVE SUITE 1329
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City | CHICAGO
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State | IL
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Zip | 60602-3402
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Country | US
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Telephone | 312-782-2844
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Fax | 312-783-5780
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY M CROWE
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Credential | DMD
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Telephone | 312-782-2844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019017532
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License Number State | IL
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