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General NPI Number Information
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NPI Number | 1760221469
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Entity Type | Organization
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Legal Business Name | ADAM CRELL DDS, LLC
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/22/2024
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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 | 2692 WHISTLER WAY NE
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-6595
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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 | DENTIST
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Name | ADAM CRELL
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Credential | DDS
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Telephone | 302-650-8729
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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 |
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License Number State |
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