Crock, Brian E

Crock, Brian E is an individual health care provider with primary practice located at 175 Mcmillen Dr , Newark OH 43055-1810. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Crock, Brian E can be contacted via phone (740) 344-3372.

Contact Information

Primary practice address
175 Mcmillen Dr Newark OH 43055-1810
Phone: (740) 344-3372
Fax: (740) 344-2552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 19260 Ohio

Profile Details

NPI number 1366413528
LBN Legal business name Crock, Brian E
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366413528 NPPES
Ohio MEDICAID 0970436

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