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Individual

HEATHER MARIE CROCKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
240 PARSONS AVE FL 2, COLUMBUS, OH 43215-5331
(614) 645-7487
(614) 645-7080
Mailing address
3433 AGLER RD STE 2800, COLUMBUS, OH 43219-3389
(614) 859-1906
(614) 458-1849

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
010471
CT
1223G0001X
General Practice Dentistry
Primary
30.023011
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0189670
OH
Enumeration date
06/04/2008
Last updated
09/12/2025
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