Organization
CROCKETT DENTAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH HENDERSON HOLCOMB DDS (PRESIDENT)
(936) 544-3554
Entity
Organization
Contact information
Practice address
1050 E LOOP 304 STE 120, CROCKETT, TX 75835-1800
(936) 544-3554
Mailing address
1050 E LOOP 304 STE 120, CROCKETT, TX 75835-1800
(936) 544-3554
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17145
TX
122300000X
Dentist
8092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598873614
HUMANA
TX
01
—
1942318035
HUMANA
TX
Enumeration date
03/16/2016
Last updated
03/16/2016
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