Individual
DR. JOHN MAX CRESTETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MD
Contact information
Practice address
901 N WINSTEAD AVE, SUITE 130, ROCKY MOUNT, NC 27804-8467
(252) 443-7331
(252) 937-2381
Mailing address
901 N WINSTEAD AVE, SUITE 130, ROCKY MOUNT, NC 27804-8467
(252) 443-7331
(252) 937-2381
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6759
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102X
—
NC
05
—
8990023
—
NC
Enumeration date
10/26/2006
Last updated
02/20/2012
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