Individual
MARIE CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
750 VENANGO AVE, CAMBRIDGE SPRINGS, PA 16403
(814) 398-2656
(814) 398-1438
Mailing address
750 VENANGO AVE, CAMBRIDGE SPRINGS, PA 16403
(814) 398-2656
(814) 398-1438
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS028556L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001657950001
DEPT OF PUBLIC AID
PA
Enumeration date
08/10/2006
Last updated
01/18/2012
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