| NPI | 1972392751 |
|---|---|
| Doing Business As | CRYSTAL COVE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | FLORENTINA CAMACHO Office Manager 708-614-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |