| David S. Crockett Dds Inc | |
|
22296 Main St Hayward CA 94541-4005 | |
| (510) 581-1122 | |
| (510) 581-1043 |
| Full Name | David S. Crockett Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 22296 Main St, Hayward, California |
| Authorized Official Name and Position | David Sanders Crockett (DENTIST) |
| Authorized Official Contact | 5105811122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David S. Crockett Dds Inc 22296 Main St Hayward CA 94541-4005 Ph: (510) 581-1122 | David S. Crockett Dds Inc 22296 Main St Hayward CA 94541-4005 Ph: (510) 581-1122 |
| NPI Number | 1366468530 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366468530 | NPI | - | NPPES |
| B26977 | Other | CA | MEDICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 26977 (California) | Primary |
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