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General NPI Number Information
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NPI Number | 1578468815
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Entity Type | Individual
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Provider Name | MR. NICHOLAS MICHAEL CROWTON
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Gender | Male
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 10894 S RIVER FRONT PKWY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5609
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Country | US
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Telephone | 801-878-1233
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Fax |
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Provider Business Mailing Address
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Address Line | 1664 DARLING ST
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City | OGDEN
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State | UT
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Zip | 84403-0559
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Country | US
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Telephone | 801-644-9935
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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 | AEGD1564
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License Number State | UT
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