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General NPI Number Information
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NPI Number | 1770794612
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Entity Type | Organization
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Legal Business Name | JOHN E. CROSLAND DDS
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 901 N LAFAYETTE ST SUITE A
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City | SHELBY
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State | NC
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Zip | 28150-3832
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Country | US
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Telephone | 704-484-0148
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Fax | 704-484-0148
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Provider Business Mailing Address
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Address Line | 901-A NORTH LAFAYETTE ST.
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City | SHELBY
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State | NC
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Zip | 28150
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Country | US
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Telephone | 704-484-0148
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Fax | 704-484-0148
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. JOHN EVERETT CROSLAND
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Credential | DDS
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Telephone | 704-484-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | NC4891
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License Number State | NC
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