Organization
DAVID S. CROCKETT DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SANDERS CROCKETT DDS (DENTIST)
(510) 581-1122
Entity
Organization
Contact information
Practice address
22296 MAIN ST, HAYWARD, CA 94541-4005
(510) 581-1122
(510) 581-1043
Mailing address
22296 MAIN ST, HAYWARD, CA 94541-4005
(510) 581-1122
(510) 581-1043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26977
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B26977
MEDICAL
CA
Enumeration date
07/14/2006
Last updated
08/22/2020
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