Individual
DR. LYNETTE S CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6104 FAYETTEVILLE ROAD, SUITE 104, DURHAM, NC 27713-6283
(919) 544-6727
(919) 484-1434
Mailing address
6104 FAYETTEVILLE ROAD, SUITE 104, DURHAM, NC 27713-6283
(919) 544-6727
(919) 484-1434
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6727
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899009V
—
NC
Enumeration date
10/03/2006
Last updated
11/19/2013
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