Crestway Park Dental, P.a.

NPI #1508021114 in Athens, Texas

Provider Information

NPI Number: 1508021114
Entity Type: Organization
Organization Name: Crestway Park Dental, P.a.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 23, 2008
Last Updated: Apr 14, 2022

Practice Location

Address: 208 CRESTWAY ST
City: Athens
State: Texas
ZIP Code: 75751
Phone: (903) 675-3811

Authorized Official

Name: HANNAH LIVELY
Title: BUSINESS MANAGER
Phone: (903) 675-3811

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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