Provider Demographics
NPI:1972752707
Name:CROSSLEY, DAVID J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:CROSSLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:145 CLINTON ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3621
Mailing Address - Country:US
Mailing Address - Phone:315-788-3240
Mailing Address - Fax:315-788-1279
Practice Address - Street 1:145 CLINTON ST
Practice Address - Street 2:SUITE 112
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3621
Practice Address - Country:US
Practice Address - Phone:315-788-3240
Practice Address - Fax:315-788-1279
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist