Individual
DENNIS M CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26726 CROWN VALLEY PKWY., SUITE 200 HEAD & NECK ASSOCIATES OF ORANGE COUNTY, MISSION VIEJO, CA 92691
(949) 364-4361
(949) 364-4495
Mailing address
26726 CROWN VALLEY PKWY., SUITE 200 HEAD & NECK ASSOCIATES OF ORANGE COUNTY, MISSION VIEJO, CA 92691
(949) 364-4361
(949) 364-4495
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
G42104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G421040
—
CA
01
—
W8109
GEL PTAN
—
Enumeration date
07/21/2006
Last updated
11/26/2008
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