Individual
DR. DEIDRE BERGER CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
5251 FOREST DR, COLUMBIA, SC 29206-4920
(803) 787-9793
(803) 738-0300
Mailing address
5251 FOREST DR, COLUMBIA, SC 29206-4920
(803) 787-9793
(803) 738-0300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4192
SC
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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