Provider Demographics
NPI:1326735010
Name:MCCROY, JEFFREY ANDREW JR (RDH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ANDREW
Last Name:MCCROY
Suffix:JR
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 MIL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:94433
Mailing Address - Country:US
Mailing Address - Phone:253-966-9960
Mailing Address - Fax:
Practice Address - Street 1:9119 MIL PARK AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:94433
Practice Address - Country:US
Practice Address - Phone:253-966-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist