MEDICARE: JODY LYNN CROWL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	1965	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5510839	OTHER	MT	BLUE CHIP

General Provider Information

NPI Number	:	1700997608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODY LYNN CROWL DDS

Provider Business Mailing Address
First Line	:	PO BOX 338
Second Line	:
City	:	LAUREL
State	:	MT
Zip	:	59044
Country	:	US
Telephone Number	:	406-628-8741
Fax Number	:	406-633-4226

Provider Business Practice Location Address
First Line	:	113 W MAIN ST
Second Line	:
City	:	LAUREL
State	:	MT
Zip	:	59044
Country	:	US
Telephone Number	:	406-628-8741
Fax Number	:	406-633-4226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/01/2025

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