# CROWN HILL DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699115253
- **Authorized official:** DR. GEORGE THOMAS CLOYD DDS (MANAGING PARTNER)
- **Authorized official phone:** (765) 832-7741

## Contact information

- **Practice address:** 1792 E STATE HIGHWAY 163, CLINTON, IN 47842-0160
- **Practice address phone:** (765) 832-7741
- **Practice address fax:** (765) 832-7743
- **Mailing address:** 1792 E STATE ROAD 163, PO BOX 408, CLINTON, IN 47842-7327
- **Mailing address phone:** (765) 832-7741
- **Mailing address fax:** (765) 832-7743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12006928A | IN | Yes |

## Other

- **Enumeration date:** 06/27/2013
- **Last updated:** 06/27/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1002436440A | — | IN |