Individual
RUSSELL JOHN CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5533 E BELL RD STE 120, SCOTTSDALE, AZ 85254-1256
(520) 560-1690
Mailing address
5533 E BELL RD STE 120, SCOTTSDALE, AZ 85254-1256
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
D009803
AZ
Other
Enumeration date
08/10/2017
Last updated
02/10/2018
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