Provider Demographics
NPI:1023231669
Name:CROSSETTI, HENRY WILLIAM (DDS MS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:WILLIAM
Last Name:CROSSETTI
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 E WOODFIELD ROAD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-605-0280
Mailing Address - Fax:847-605-0288
Practice Address - Street 1:1701 E WOODFIELD ROAD
Practice Address - Street 2:SUITE 510
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-605-0280
Practice Address - Fax:847-605-0288
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics