Individual
DR. CHARLES L. CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
952 MAHAN DR, MONTICELLO, FL 32344-1136
(850) 997-3984
Mailing address
952 W MAHAN DR, MONTICELLO, FL 32344
(850) 997-3984
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 7229
FL
Other
Enumeration date
08/01/2006
Last updated
07/21/2022
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