# CRESTWOOD FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215913900
- **Authorized official:** EDWARD POLLER (PRESIDENT)
- **Authorized official phone:** (732) 914-1039

## Contact information

- **Practice address:** 70 LACEY RD, WHITING, NJ 08759-2931
- **Practice address phone:** (732) 350-7999
- **Practice address fax:** (732) 350-7961
- **Mailing address:** 16 WASHINGTON ST, TOMS RIVER, NJ 08753-7643
- **Mailing address phone:** (732) 914-1039
- **Mailing address fax:** (732) 914-8472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2005
- **Last updated:** 01/03/2008