Provider Demographics
NPI:1033251178
Name:CRANE, JOHN H
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:CRANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-3751
Mailing Address - Country:US
Mailing Address - Phone:336-786-5045
Mailing Address - Fax:336-789-7245
Practice Address - Street 1:304 E INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-3751
Practice Address - Country:US
Practice Address - Phone:336-786-5045
Practice Address - Fax:336-789-7245
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC44751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice