Provider Demographics
NPI:1285736140
Name:CROHIN, MICHELE (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:CROHIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:NAHANT
Mailing Address - State:MA
Mailing Address - Zip Code:01908-1124
Mailing Address - Country:US
Mailing Address - Phone:781-495-8554
Mailing Address - Fax:781-592-0176
Practice Address - Street 1:10 E EMERSON ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3521
Practice Address - Country:US
Practice Address - Phone:781-665-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics