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General NPI Number Information
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NPI Number | 1104712579
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Entity Type | Individual
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Provider Name | CALEB AARON CROW DDS
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Gender | Male
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 308 N JAMES ST
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City | JACKSONVILLE
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State | AR
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Zip | 72076-4018
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Country | US
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Telephone | 501-436-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 13105 MORRISON RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-3738
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Country | US
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Telephone | 501-470-5510
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4860
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License Number State | AR
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