Organization
CROCO ORTHODONTICS P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW A.T. CROCO DDS, MS (OWNER)
(319) 545-7600
Entity
Organization
Contact information
Practice address
2451 CORAL CT STE 2, CORALVILLE, IA 52241-2837
(319) 545-7600
(319) 545-7640
Mailing address
2451 CORAL CT STE 2, CORALVILLE, IA 52241-2837
(319) 545-7600
(319) 545-7640
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
08174
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0463018
—
IA
Enumeration date
05/21/2008
Last updated
05/21/2008
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