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Individual
DR. SAMUEL DALTON CROCCO
Active
Individual
DR. SAMUEL DALTON CROCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60968401
WA
1223G0001X
General Practice Dentistry
60968401
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60968401
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
06/28/2019
Last updated
06/28/2019
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