Organization
LARRY W. CROCKER DMD, PC
Active
Other names
Dentistry with TLC
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY PRUETT (OFFICE MANAGER)
(618) 466-0733
Entity
Organization
Contact information
Practice address
1317 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1686
(618) 466-0733
(618) 466-1433
Mailing address
1317 D' ADRIAN PROFESSIONAL PARK, GODFREY, IL 62035
(618) 466-0733
(618) 466-1433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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