Organization
CRESTON DENTAL-1, P.C.
Active
Other names
Kool Smiles SC, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TU TRAN DDS (PRESIDENT)
(770) 916-9000
Entity
Organization
Contact information
Practice address
3112 N MAIN ST, ANDERSON, SC 29621-2763
(678) 904-5665
(678) 904-5669
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 916-5036
(678) 285-4760
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
10/25/2006
Last updated
05/13/2019
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