Individual
DR. BRIAN E CROCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
175 MCMILLEN DR, NEWARK, OH 43055-1810
(740) 344-3372
(740) 344-2552
Mailing address
175 MCMILLEN DR, NEWARK, OH 43055-1810
(740) 344-3372
(740) 344-2552
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19260
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0970436
—
OH
Enumeration date
01/27/2006
Last updated
07/08/2007
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