| Crestwood Family Dental | |
|
70 Lacey Rd Whiting NJ 08759-2931 | |
| (732) 350-7999 | |
| (732) 350-7961 |
| Full Name | Crestwood Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 70 Lacey Rd, Whiting, New Jersey |
| Authorized Official Name and Position | Sundeep C Johal (PRESIDENT) |
| Authorized Official Contact | 7327134768 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Family Dental 194 Pleasant Valley Rd Morganville NJ 07751-4438 Ph: (732) 887-8734 | Crestwood Family Dental 70 Lacey Rd Whiting NJ 08759-2931 Ph: (732) 350-7999 |
| NPI Number | 1730483496 |
|---|---|
| Provider Enumeration Date | 01/10/2011 |
| Last Update Date | 01/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730483496 | NPI | - | NPPES |
| 0021547 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21313 (New Jersey) | Primary |
Crestwood Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Lacey Rd, Whiting, NJ 08759 Phone: 732-350-7999 Fax: 732-350-7961 |