Provider Demographics
NPI:1568469617
Name:CROOK, ADON EMERY (DDS)
Entity Type:Individual
Prefix:
First Name:ADON
Middle Name:EMERY
Last Name:CROOK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1798 S WEST TEMPLE
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84115-1874
Mailing Address - Country:US
Mailing Address - Phone:801-412-6933
Mailing Address - Fax:801-412-6950
Practice Address - Street 1:461 S 400 E
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84111-3302
Practice Address - Country:US
Practice Address - Phone:801-539-8617
Practice Address - Fax:801-537-7238
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4864730-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist