Provider Demographics
NPI:1578558953
Name:KRESIN, JOHN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:KRESIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 94
Mailing Address - Street 2:BOX 2756
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09824-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 MDG/SGD
Practice Address - Street 2:UNIT 5210 BOX 230
Practice Address - City:BRANDON
Practice Address - State:GREAT BRITAIN
Practice Address - Zip Code:IP27 9PN
Practice Address - Country:GB
Practice Address - Phone:0163-852-8806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE 0144121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice