Healthcare Provider Details

I. General information

NPI: 1366218125
Provider Name (Legal Business Name): H. ALEXANDER CRISP, DMD 2, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 04/26/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HOLLY HILL LN
BURLINGTON NC
27215-5210
US

IV. Provider business mailing address

1 HULME CT
GREENSBORO NC
27455-9331
US

V. Phone/Fax

Practice location:
  • Phone: 336-677-4667
  • Fax:
Mailing address:
  • Phone: 252-292-1349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: AMY BROOKS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 252-292-1349