Michael Crockett, DDS

NPI #1053335950 in Mesa, Arizona

Provider Information

NPI Number: 1053335950
Entity Type: Individual
Name: Michael Crockett, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jul 26, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 31 S 63RD ST
Address 2: SUITE 5
City: Mesa
State: Arizona
ZIP Code: 85206-1606
Phone: (480) 981-0203

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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