Crockett, Russell John
Crockett, Russell John is an sole proprietor health care provider with primary practice located at 5533 E Bell Rd Ste 120 , Scottsdale AZ 85254-1256. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Crockett, Russell John can be contacted via phone (520) 560-1690.Contact Information
Primary practice address
5533 E Bell Rd Ste 120
Scottsdale AZ 85254-1256
Phone: (520) 560-1690
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Prosthodontics | 1223P0700X | D009803 | Arizona |
Profile Details
| NPI number | 1720503758 |
|---|---|
| LBN Legal business name | Crockett, Russell John |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2017 |
| Last updated | Feb 10th, 2018 - about 6 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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