Provider Demographics
NPI:1306287495
Name:CREWS, TYLER ANDREW (DMD)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:ANDREW
Last Name:CREWS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2932
Mailing Address - Country:US
Mailing Address - Phone:314-961-3244
Mailing Address - Fax:
Practice Address - Street 1:20 W LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-2932
Practice Address - Country:US
Practice Address - Phone:314-961-3244
Practice Address - Fax:866-670-0945
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014029153122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist