MEDICARE: MS. MARGARET MARY CATHERINE CROWLEY RDH

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	124Q00000X	Dental Hygienist	2902020316	MI

General Provider Information

NPI Number	:	1760227037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET MARY CATHERINE CROWLEY RDH

Provider Business Mailing Address
First Line	:	2309 GROESBECK AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-3452
Country	:	US
Telephone Number	:	517-802-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 60TH ST SE STE 200
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49548-9685
Country	:	US
Telephone Number	:	517-802-0044
Fax Number	:

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

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/28/2024

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