Crockett Pediatric Dentistry, P.a. is a Pediatric Dental Clinic in Greenville, South Carolina. It is located at 102 S Venture Dr, Greenville, SC and its contact number is 864-234-9800. The authorized person for Crockett Pediatric Dentistry, P.a. is Mr. Jerry W. Crockett
who is Business Manager of the clinic and their contact number is 864-234-9800. The primary license number for Crockett Pediatric Dentistry, P.a. is SC3486 (Pediatric Dentistry) in South Carolina. Crockett Pediatric Dentistry, P.a. Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Crockett Pediatric Dentistry, P.a. Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Crockett Pediatric Dentistry, P.a.
Specialization:
Pediatric Dentistry
Clinic Address:
102 S Venture Dr, Greenville, South Carolina, 29615-3571
Phone:
864-234-9800
Fax:
864-234-9820
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Jerry W. Crockett
Position:
Business Manager
Contact Number:
864-234-9800
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Crockett Pediatric Dentistry, P.a. clinic are as mentioned below.
NPI Number:
1124245626
NPI Enumeration Date:
19 Apr, 2007
NPI Last Update On:
22 Aug, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Crockett Pediatric Dentistry, P.a. are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
SC3486
South Carolina
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
ZA9507
Medicaid
South Carolina
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Crockett Pediatric Dentistry, P.a. 102 S Venture Dr, Greenville, South Carolina
Zip:
29615-3571
Phone Number:
864-234-9800
Fax Number:
864-234-9820
Patients can reach Crockett Pediatric Dentistry, P.a. at 102 S Venture Dr, Greenville, South Carolina or can call to book an appointment on 864-234-9800. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.