Individual
DR. G ROLAND CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
320 12TH STREET, HUNTINGTON, WV 25701
(304) 525-8056
(304) 525-8064
Mailing address
320 12TH STREET, HUNTINGTON, WV 25701
(304) 525-8056
(304) 525-8064
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2221
WV
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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