Provider Demographics
NPI:1548297476
Name:CROWLEY, JOHN F (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-973-5035
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:WEBBER WEST SUITE 340
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-973-7000
Practice Address - Fax:207-973-5042
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME3771204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
V08300Medicare UPIN
V08300Medicare UPIN