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General NPI Number Information
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NPI Number | 1033328414
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Entity Type | Individual
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Provider Name | MICHELLE B CREWS DMD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 12/14/2014
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Provider Practice Location Address
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Address Line | 141 TOWNSHIP AVE SUITE 111
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City | RIDGELAND
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State | MS
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Zip | 39157-8694
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Country | US
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Telephone | 769-257-0399
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Fax |
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Provider Business Mailing Address
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Address Line | 141 TOWNSHIP AVE SUITE 111
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City | RIDGELAND
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State | MS
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Zip | 39157-8694
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Country | US
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Telephone | 769-257-0399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3311-04
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License Number State | MS
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