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General NPI Number Information
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NPI Number | 1295932192
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Entity Type | Individual
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Provider Name | MICHAEL BRADLEY CROWLEY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18001 N 79TH AVE STE B16
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City | GLENDALE
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State | AZ
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Zip | 85308-8390
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Country | US
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Telephone | 623-486-9333
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Fax |
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Provider Business Mailing Address
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Address Line | 8201 N 21ST DR # C-106
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City | PHOENIX
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State | AZ
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Zip | 85021-4941
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Country | US
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Telephone | 602-791-0064
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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 | D7307
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License Number State | AZ
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