Provider Demographics
NPI:1952376931
Name:JAMES E CRENSHAW & WILLIAM C HAIGHT DDS PA
Entity Type:Organization
Organization Name:JAMES E CRENSHAW & WILLIAM C HAIGHT DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:CRENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-257-3736
Mailing Address - Street 1:202 GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589
Mailing Address - Country:US
Mailing Address - Phone:252-257-3736
Mailing Address - Fax:252-257-2708
Practice Address - Street 1:202 GRAHAM ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589
Practice Address - Country:US
Practice Address - Phone:252-257-3736
Practice Address - Fax:252-257-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005122300000X
NC6766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012A8OtherBCBS