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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