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General NPI Number Information
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NPI Number | 1407750458
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Entity Type | Organization
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Legal Business Name | CREWS DENTAL LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 4224 WATSON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63109-1271
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Country | US
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Telephone | 314-832-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 20 W LOCKWOOD AVE
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-2932
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Country | US
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Telephone | 314-961-3244
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TYLER CREWS
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Credential | DMD
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Telephone | 314-961-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | NULL
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