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DR. JOHN EVERETT CROSLAND D.D.S.

Periodontics

Shelby, North Carolina

Provider NPI: 1245313600

Provider Information:
DR. JOHN EVERETT CROSLAND D.D.S.
Gender: M
Sole Proprietor


Practice Location:
901 N LAFAYETTE ST SUITE A SHELBY, NC 28150 US
Tel: 704-484-0148  Fax: 704-484-0148

Business Mailing Address:
901 N LAFAYETTE ST SUITE A SHELBY, NC 28150 US
Tel: 704-484-0148  Fax: 704-484-0148

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0300XDental Providers
Dentist
Periodontics
NCNC4891

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD91901NC01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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