Provider Demographics
NPI:1861518045
Name:CROW, ANDREW EARL (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EARL
Last Name:CROW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508A VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1848
Mailing Address - Country:US
Mailing Address - Phone:715-344-6390
Mailing Address - Fax:715-344-9888
Practice Address - Street 1:508A VINCENT ST
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1848
Practice Address - Country:US
Practice Address - Phone:715-344-6390
Practice Address - Fax:715-344-9888
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5607-015261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental