Crestetto, John Max

Crestetto, John Max is an individual health care provider with primary practice located at 901 N Winstead Ave Suite 130, Rocky Mount NC 27804-8467. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Crestetto, John Max can be contacted via phone (252) 443-7331.

Contact Information

Primary practice address
901 N Winstead Ave Suite 130 Rocky Mount NC 27804-8467
Phone: (252) 443-7331
Fax: (252) 937-2381
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 6759 North Carolina

Profile Details

NPI number 1063597375
LBN Legal business name Crestetto, John Max
Credentials DDS,MD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Feb 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063597375 NPPES
North Carolina MEDICAID 0102X
North Carolina MEDICAID 8990023

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