Crescent Family Dental LLC

NPI #1043749286 in Wheeling, Illinois

Provider Information

NPI Number: 1043749286
Entity Type: Organization
Organization Name: Crescent Family Dental LLC
Primary Specialty: Dentist
Enumeration Date: Jun 10, 2017
Last Updated: Jun 25, 2020

Practice Location

Address: 307 S MILWAUKEE AVE STE 101
City: Wheeling
State: Illinois
ZIP Code: 60090-5035
Phone: (847) 459-3366

Authorized Official

Name: DR. DEEPTHA SURAMPUDI, DDS
Title: PRESIDENT
Phone: (224) 229-9688

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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