Provider Demographics
NPI:1225274897
Name:CHRYSTAL T. ROOKS, DDS, PA
Entity Type:Organization
Organization Name:CHRYSTAL T. ROOKS, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRYSTAL
Authorized Official - Middle Name:TURNER
Authorized Official - Last Name:ROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-568-3711
Mailing Address - Street 1:303 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PINK HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28572-8045
Mailing Address - Country:US
Mailing Address - Phone:252-568-3711
Mailing Address - Fax:252-568-3129
Practice Address - Street 1:303 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PINK HILL
Practice Address - State:NC
Practice Address - Zip Code:28572-8045
Practice Address - Country:US
Practice Address - Phone:252-568-3711
Practice Address - Fax:252-568-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-01
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8443261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental