Individual
DR. MICHELLE CHRISTINE CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
11786 SW BARNES RD STE 320, PORTLAND, OR 97225-5930
(503) 641-3550
Mailing address
11786 SW BARNES RD STE 320, PORTLAND, OR 97225-5930
(503) 641-3550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8443
OR
Other
Enumeration date
05/22/2008
Last updated
10/06/2014
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