Organization
CRESCENT DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYAMACK GANJAVIAN DDS (PRESIDENT)
(302) 230-0000
Entity
Organization
Contact information
Practice address
129 S. WEST ST., WILMINGTON, DE 19801
(302) 230-0000
Mailing address
120 TALLEYRAND DR, WILMINGTON, DE 19810-3948
(302) 230-0000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
G10001184
DE
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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