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Organization

CRESTVIEW KIDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN FARRUGIA (PC HOLDER)
(850) 343-4340
Entity
Organization

Contact information

Practice address
10 RIVERWOOD DR STE B, CRESTVIEW, FL 32536-5016
(850) 343-4340
Mailing address
10 RIVERWOOD DR STE B, CRESTVIEW, FL 32536-5016

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
04/19/2022
Last updated
04/19/2022
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