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General NPI Number Information
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NPI Number | 1609759539
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Entity Type | Organization
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Legal Business Name | H. ALEXANDER CRISP DMD 4, PLLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 4201 LAKE BOONE TRL STE 2
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City | RALEIGH
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State | NC
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Zip | 27607-7511
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Country | US
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Telephone | 919-787-3949
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 LAKE BOONE TRL STE 2
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City | RALEIGH
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State | NC
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Zip | 27607-7511
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Country | US
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Telephone | 919-787-3949
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | VANESA PEDROZA
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Credential |
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Telephone | 919-787-3949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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