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General NPI Number Information
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NPI Number | 1588875850
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Entity Type | Individual
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Provider Name | ROY ERVIN CROWE JR. D.D.S.P.C.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 6128 PRESTLEY MILL ROAD SUITE E
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City | DOUGLASVILLE
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State | GA
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Zip | 30134
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Country | US
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Telephone | 770-949-8822
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Fax | 770-949-5407
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Provider Business Mailing Address
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Address Line | PO BOX 5364
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City | DOUGLASVILLE
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State | GA
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Zip | 30154-0007
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Country | US
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Telephone | 770-855-9594
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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 | DN009030
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License Number State | GA
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