| Crest Family Dental, Llc | |
|
85 Seymour St Suite 1018 Hartford CT 06106-5501 | |
| (860) 251-6999 | |
| (860) 251-6997 |
| Full Name | Crest Family Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 85 Seymour St, Hartford, Connecticut |
| Authorized Official Name and Position | Shyam Shivareddy (MANAGER) |
| Authorized Official Contact | 9045141217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crest Family Dental, Llc 85 Seymour St Suite 1018 Hartford CT 06106-5501 Ph: (860) 251-6999 | Crest Family Dental, Llc 85 Seymour St Suite 1018 Hartford CT 06106-5501 Ph: (860) 251-6999 |
| NPI Number | 1699185264 |
|---|---|
| Provider Enumeration Date | 05/05/2014 |
| Last Update Date | 05/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699185264 | NPI | - | NPPES |
| 1223G0001X | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | CT10690 (Connecticut) | Primary |
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