institution
Crockett Pediatric Dentistry, P.a.
Pediatric Dentist in Greenville, South Carolina
NPI 1124245626

Crockett Pediatric Dentistry, P.a. is a Pediatric Dentist based in Greenville, SC and is specialized in Pediatric Dentistry. Crockett Pediatric Dentistry, P.a. practices in Greenville, SC. The NPI Number for Crockett Pediatric Dentistry, P.a. is 1124245626 and holds a License No. SC3486 (South Carolina).

The current practice location address for Crockett Pediatric Dentistry, P.a. is 102 S Venture Dr, Greenville, SC and can be reached out via phone at 864-234-9800 and via fax at 864-234-9820. You can also correspond with Crockett Pediatric Dentistry, P.a. through the mailing address at 102 S VENTURE DR, GREENVILLE, SC - 29615-3571 (mailing address contact number: 864-234-9800).

Location: 102 S Venture Dr, Greenville, SC, 29615-3571
institution
Provider Profile Details
NPI Number
1124245626
Provider Name
Crockett Pediatric Dentistry, P.a.
Credential
Provider Entity Type
Organization
Address
102 S Venture Dr, Greenville, SC, 29615-3571
Phone Number
864-234-9800
Fax Number
864-234-9820
Provider Enumeration Date
04/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZA9507 05 SC
institution
Provider Business Practice Location Address Details
Address
102 S Venture Dr
City
State
Zip
29615-3571
Phone Number
864-234-9800
Fax Number
864-234-9820
person
Provider Business Mailing Address Details
Address
102 S Venture Dr
City
State
Zip
29615-3571
Phone Number
864-234-9800
Fax Number
864-234-9820
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
SC3486 (South Carolina)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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