DR. Larry Wayne Crocker, D.M.D.

NPI #1588617518 in Godfrey, Illinois

Provider Information

NPI Number
1588617518
Entity Type
Individual
Name
DR. Larry Wayne Crocker, D.M.D.
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Dentist - General Practice
Credential
D.M.D.
Enumeration Date
May 19, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
1317 DADRIAN PROFESSIONAL PARK
ZIP Code
62035-1686
Phone
(618) 466-0733

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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