Michelle C. Crocker, Dmd, PC

NPI #1235456153 in Portland, Oregon

Provider Information

NPI Number: 1235456153
Entity Type: Organization
Organization Name: Michelle C. Crocker, Dmd, PC
Primary Specialty: Dentist
Enumeration Date: May 2, 2010
Last Updated: May 2, 2010

Practice Location

Address: 11786 SW BARNES RD STE 320
City: Portland
State: Oregon
ZIP Code: 97225-5930
Phone: (503) 641-3550

Authorized Official

Name: DR. MICHELLE C CROCKER, DMD
Title: PRESIDENT
Phone: (503) 515-6092

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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