| Lily B And Samuel D Crocco Dmd Pllc | |
|
358 Front Ave Nw Castle Rock WA 98611-8996 | |
| (760) 750-0087 | |
| Not Available |
| Full Name | Lily B And Samuel D Crocco Dmd Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 358 Front Ave Nw, Castle Rock, Washington |
| Authorized Official Name and Position | Lily Crocco (OWNER DENTIST) |
| Authorized Official Contact | 7607500087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lily B And Samuel D Crocco Dmd Pllc 25642 Berryhill Rd Eagle River AK 99577-9603 Ph: (760) 750-0087 | Lily B And Samuel D Crocco Dmd Pllc 358 Front Ave Nw Castle Rock WA 98611-8996 Ph: (760) 750-0087 |
| NPI Number | 1053143073 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053143073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
L. Blaine Kennington, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 358 Front Ave Nw, Castle Rock, WA 98611 Phone: 360-274-9100 Fax: 360-274-8152 |