Provider Demographics
NPI:1760221469
Name:ADAM CRELL DDS, LLC
Entity type:Organization
Organization Name:ADAM CRELL DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-650-8729
Mailing Address - Street 1:2692 WHISTLER WAY NE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6595
Mailing Address - Country:US
Mailing Address - Phone:302-650-8729
Mailing Address - Fax:
Practice Address - Street 1:697 MEDICAL PARK LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2084
Practice Address - Country:US
Practice Address - Phone:770-718-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty