| Howard L. Crystal, D.d.s., P.c. | |
|
929 Ridge Rd. Wilmette IL 60091-1559 | |
| (847) 906-3480 | |
| Not Available |
| Full Name | Howard L. Crystal, D.d.s., P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 929 Ridge Rd., Wilmette, Illinois |
| Authorized Official Name and Position | Howard Lawrence Crystal (PRESIDENT) |
| Authorized Official Contact | 7733706307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard L. Crystal, D.d.s., P.c. 929 Ridge Rd. Wilmette IL 60091-1559 Ph: (847) 906-3480 | Howard L. Crystal, D.d.s., P.c. 929 Ridge Rd. Wilmette IL 60091-1559 Ph: (847) 906-3480 |
| NPI Number | 1124490875 |
|---|---|
| Provider Enumeration Date | 10/21/2015 |
| Last Update Date | 10/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124490875 | NPI | - | NPPES |
| 9178032 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019016617 (Illinois) | Primary |
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