| Crystal Family Dental Care | |
|
1560 Carlemont Dr Crystal Lake IL 60014-2740 | |
| (630) 656-2213 | |
| (779) 220-4972 |
| Full Name | Crystal Family Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 1560 Carlemont Dr, Crystal Lake, Illinois |
| Authorized Official Name and Position | Brijesh Patel (OWNER) |
| Authorized Official Contact | 6306562213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Family Dental Care 1560 Carlemont Dr Crystal Lake IL 60014-2740 Ph: (630) 656-2213 | Crystal Family Dental Care 1560 Carlemont Dr Crystal Lake IL 60014-2740 Ph: (630) 656-2213 |
| NPI Number | 1982058848 |
|---|---|
| Provider Enumeration Date | 04/18/2016 |
| Last Update Date | 12/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982058848 | NPI | - | NPPES |
| 019029358 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019029358 (Illinois) | Primary |
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