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General NPI Number Information
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NPI Number | 1225352289
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Entity Type | Organization
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Legal Business Name | CROFT ORTHODONTICS PLLC
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 9772 W YEARLING RD STE A1600
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City | PEORIA
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State | AZ
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Zip | 85383-1380
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Country | US
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Telephone | 623-566-0800
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Fax | 833-330-2854
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Provider Business Mailing Address
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Address Line | 9772 W YEARLING RD STE A1600
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City | PEORIA
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State | AZ
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Zip | 85383-1380
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Country | US
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Telephone | 623-566-0800
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Fax | 623-566-0860
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | DR. DEVIN L CROFT
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Credential | DDS, MS
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Telephone | 623-566-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7616
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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