Organization
CRESTA DENTAL IMPLANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL SANDISH (ADMIN ASST)
(216) 485-5788
Entity
Organization
Contact information
Practice address
7081 PEARL ROAD, MIDDLEBURG HEIGHTS, OH 44130-8361
(216) 282-1491
(216) 920-9592
Mailing address
6700 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3285
(216) 485-5788
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
30-025207
OH
1223E0200X
Endodontics
30-025210
OH
1223G0001X
General Practice Dentistry
30-015265
OH
1223P0300X
Periodontics
30-025209
OH
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/28/2017
Last updated
06/17/2021
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