Organization
CREST DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMI K SHAH D.D.S (DENTIST)
(847) 361-2400
Entity
Organization
Contact information
Practice address
1354 W ARMY TRAIL RD, CAROL STREAM, IL 60188-4836
(847) 361-2400
(630) 289-6870
Mailing address
1354 W ARMY TRAIL RD, CAROL STREAM, IL 60188-4836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.027379
IL
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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