Organization
COMPREHENSIVE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YASMI O CRYSTAL DMD (OWNER)
(732) 356-1830
Entity
Organization
Contact information
Practice address
111 E UNION AVE, BOUND BROOK, NJ 08805-1761
(732) 356-1830
Mailing address
111 E UNION AVE, BOUND BROOK, NJ 08805-1761
(732) 356-1830
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DI15948
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188395
—
NJ
Enumeration date
07/28/2009
Last updated
07/28/2009
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