| Michelle C. Crocker, Dmd, Pc | |
|
11786 Sw Barnes Rd Ste 320 Portland OR 97225-5930 | |
| (503) 641-3550 | |
| Not Available |
| Full Name | Michelle C. Crocker, Dmd, Pc |
|---|---|
| Speciality | Dentist |
| Location | 11786 Sw Barnes Rd Ste 320, Portland, Oregon |
| Authorized Official Name and Position | Michelle C Crocker (PRESIDENT) |
| Authorized Official Contact | 5035156092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle C. Crocker, Dmd, Pc 13195 Sw Shore Dr Tigard OR 97223-1683 Ph: (503) 641-3550 | Michelle C. Crocker, Dmd, Pc 11786 Sw Barnes Rd Ste 320 Portland OR 97225-5930 Ph: (503) 641-3550 |
| NPI Number | 1235456153 |
|---|---|
| Provider Enumeration Date | 05/02/2010 |
| Last Update Date | 05/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235456153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D8443 (Oregon) | Primary |
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