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General NPI Number Information
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NPI Number | 1003303579
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Entity Type | Individual
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Provider Name | ADAM CRELL DDS
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Gender | Male
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 01/13/2024
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Provider Practice Location Address
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Address Line | 697 MEDICAL PARK LN
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City | GAINESVILLE
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State | GA
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Zip | 30501-2084
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Country | US
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Telephone | 770-718-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 338 ESTATES DR
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City | CAMDEN WYOMING
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State | DE
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Zip | 19934-4616
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Country | US
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Telephone | 302-650-8729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN23395
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN123295
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License Number State | GA
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