Organization
PEDIATRIC DENTISTRY OF OWENSBORO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES P. CREWS DMD (DMD/OWNER)
(270) 683-7447
Entity
Organization
Contact information
Practice address
2200 E PARRISH AVE, C-202, OWENSBORO, KY 42303-1449
(270) 683-7447
Mailing address
2200 E PARRISH AVE, C-202, OWENSBORO, KY 42303-1449
(270) 683-7447
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7748
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60002078
—
KY
Enumeration date
11/17/2011
Last updated
11/17/2011
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