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Organization

DR ROSLYN M. CRISP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOROTHY L CORBETT (FINANCIAL)
(336) 228-8392
Entity
Organization

Contact information

Practice address
1203 VAUGHN RD, BURLINGTON, NC 27217-2846
(336) 228-8392
(336) 227-0635
Mailing address
1203 VAUGHN RD, BURLINGTON, NC 27217-2846
(336) 228-8392
(336) 227-0635

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14816
DORAL DENTAL
WI
05
14816
VA
05
8991896
NC
Enumeration date
04/01/2008
Last updated
04/01/2008
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