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NPI Code Detail

MEDICARE: RICHARD CROXTON JR. DDS

MEDICARE:   RICHARD  CROXTON JR. DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist3435NC

General Provider Information

NPI Number : 1205182755
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD CROXTON JR. DDS
Provider Business Mailing Address
First Line : 530 N ELAM AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1153
Country : US
Telephone Number : 336-854-0330
Fax Number :
Provider Business Practice Location Address
First Line : 530 N ELAM AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1153
Country : US
Telephone Number : 336-854-0330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2012
Last Update Date : 08/01/2012

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