Individual
JUSTIN CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9778 KATY FWY STE 450, HOUSTON, TX 77055-6234
(936) 443-7366
Mailing address
811 E HEIGHTS HOLLOW LN, HOUSTON, TX 77007-7073
(936) 443-7366
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24782
TX
Other
Enumeration date
06/27/2011
Last updated
07/01/2011
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