| Crocker Family Dental | |
|
109 Monument Place Vicksburg MS 39180 | |
| (601) 638-3661 | |
| (601) 631-0401 |
| Full Name | Crocker Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 109 Monument Place, Vicksburg, Mississippi |
| Authorized Official Name and Position | Jordan P Crocker (OWNER) |
| Authorized Official Contact | 6016383661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crocker Family Dental 109 Monument Place Vicksburg MS 39180 Ph: (601) 638-3661 | Crocker Family Dental 109 Monument Place Vicksburg MS 39180 Ph: (601) 638-3661 |
| NPI Number | 1962802710 |
|---|---|
| Provider Enumeration Date | 08/29/2014 |
| Last Update Date | 01/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962802710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3672-12 (Mississippi) | Primary |
Janet S Fisher Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
Southern Oral And Maxillofacial Surgery Center, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1205 Mission Park Dr, Vicksburg, MS 39180 Phone: 601-661-0034 Fax: 601-661-0367 | |
Delta Orthodontic Specialists Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2356 Grove Street, Vicksburg, MS 39183 Phone: 601-638-8230 Fax: 601-636-3388 | |
Jackson Hinds Comprehensive Health Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3312 Oak St, Vicksburg, MS 39180 Phone: 601-629-9500 Fax: 601-638-9044 | |
Margo R Marveggio Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Mission 66, Vicksburg, MS 39183 Phone: 601-636-6081 | |
Vicksburg Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
Robert A. Sadler Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1016 Mission 66, Vicksburg, MS 39183 Phone: 601-638-3661 |