| Crestview Dental Group | |
|
265 Crestview Dr Santa Clara CA 95050-6503 | |
| (408) 248-6777 | |
| Not Available |
| Full Name | Crestview Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 265 Crestview Dr, Santa Clara, California |
| Authorized Official Name and Position | Kenneth Wallis (PRESIDENT) |
| Authorized Official Contact | 4084063077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestview Dental Group 265 Crestview Dr Santa Clara CA 95050-6503 Ph: (408) 248-6777 | Crestview Dental Group 265 Crestview Dr Santa Clara CA 95050-6503 Ph: (408) 248-6777 |
| NPI Number | 1538551924 |
|---|---|
| Provider Enumeration Date | 02/23/2015 |
| Last Update Date | 02/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538551924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 34914 (California) | Primary |
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