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Organization
HOWARD L. CRYSTAL, D.D.S., P.C.
Active
Organization
HOWARD L. CRYSTAL, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD LAWRENCE CRYSTAL D.D.S. (PRESIDENT)
(773) 370-6307
Entity
Organization
Contact information
Practice address
929 RIDGE RD., WILMETTE, IL 60091-1559
(847) 906-3480
Mailing address
929 RIDGE RD., WILMETTE, IL 60091-1559
(847) 906-3480
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019016617
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178032
—
IL
Enumeration date
10/21/2015
Last updated
10/21/2015
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