Provider Demographics
NPI:1417978750
Name:CROSSETTA, WILLIAM J III (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:CROSSETTA
Suffix:III
Gender:M
Credentials:DDS
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Mailing Address - Street 1:125 LAWRENCE BELL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7817
Mailing Address - Country:US
Mailing Address - Phone:716-634-4679
Mailing Address - Fax:716-634-5415
Practice Address - Street 1:5907 S PARK AVE
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-7421
Practice Address - Country:US
Practice Address - Phone:716-646-3912
Practice Address - Fax:716-648-0311
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY0511551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice