Crockett Pediatric Dentistry, P.A. in Greenville - Pediatric Dentistry
Crockett Pediatric Dentistry, P.A. - NPI 1124245626
Crockett Pediatric Dentistry, P.A. is a Pediatric Dentistry in Greenville, South Carolina. Crockett Pediatric Dentistry, P.A. practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Crockett Pediatric Dentistry, P.A. is 1124245626. The last update date is 2020-08-22.
Crockett Pediatric Dentistry, P.A.'s current location address is 102 S Venture Dr, Greenville, South Carolina. You can contact this provider via phone number 8642349800 and fax number 8642349820. The mailing address for Crockett Pediatric Dentistry, P.A. is 102 S Venture Dr, Greenville, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Crockett Pediatric Dentistry, P.A. |
|---|---|
| Address | 102 S Venture Dr, Greenville, South Carolina |
| Phone Number | 8642349800 |
| Fax Number | 8642349820 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BUSINESS M |
|---|---|
| Authorized Official Name | Crockett W. Jerry |
| Telephone Number | 8642349800 |
NPI Number Detail
| NPI Number | 1124245626 |
|---|---|
| Provider Enumeration Date | 2007-04-19 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 102 S Venture Dr |
|---|---|
| City | Greenville |
| State | South Carolina (SC) |
| Post Code | 296153571 |
| Phone Number | 8642349800 |
| Fax Number | 8642349820 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | SC3486 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ZA9507 | SC | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Crockett Pediatric Dentistry, P.A. by the Centers for Medicare & Medicaid Services?
The Crockett Pediatric Dentistry, P.A. has been issued the NPI (National Provider Identifier) 1124245626. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Crockett Pediatric Dentistry, P.A.?
The Crockett Pediatric Dentistry, P.A. is physically situated at 102 S Venture Dr, in the city of Greenville, state of SC, with the postal code 296153571.
What is Crockett Pediatric Dentistry, P.A.'s primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Crockett Pediatric Dentistry, P.A. is Pediatric Dentistry, and the corresponding taxonomy classification code for this specialized field is 1223P0221X.
When was the Crockett Pediatric Dentistry, P.A.'s 1124245626 issued?
The Crockett Pediatric Dentistry, P.A.'s 1124245626 was issued on 2007-04-19.
When was the information regarding Crockett Pediatric Dentistry, P.A., such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Crockett Pediatric Dentistry, P.A., including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.