Individual
DR. MARK CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
919 18TH ST NW, LL-50, WASHINGTON, DC 20006-5503
(202) 223-6300
Mailing address
919 18TH ST NW, LL-50, WASHINGTON, DC 20006-5503
(202) 223-6300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN1001290
DC
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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