Organization
CRESTWOOD FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD POLLER (PRESIDENT)
(732) 914-1039
Entity
Organization
Contact information
Practice address
70 LACEY RD, WHITING, NJ 08759-2931
(732) 350-7999
(732) 350-7961
Mailing address
16 WASHINGTON ST, TOMS RIVER, NJ 08753-7643
(732) 914-1039
(732) 914-8472
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/15/2005
Last updated
01/03/2008
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