Provider Demographics
NPI:1831347681
Name:CRESCENZO, DAVID G (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:CRESCENZO
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 1:5 WEYMOUTH ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037
Mailing Address - Country:US
Mailing Address - Phone:609-561-0058
Mailing Address - Fax:609-561-7586
Practice Address - Street 1:5 WEYMOUTH ROAD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037
Practice Address - Country:US
Practice Address - Phone:609-561-0058
Practice Address - Fax:609-561-7586
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01737900122300000X
NJDI017379122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist