Provider Demographics
NPI:1780850701
Name:CRESCENTWOOD DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:CRESCENTWOOD DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMZEY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HELAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-343-5656
Mailing Address - Street 1:7002 RIVERBROOK DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6530
Mailing Address - Country:US
Mailing Address - Phone:281-343-5656
Mailing Address - Fax:281-343-5657
Practice Address - Street 1:7002 RIVERBROOK DR
Practice Address - Street 2:SUITE 800
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6530
Practice Address - Country:US
Practice Address - Phone:281-343-5656
Practice Address - Fax:281-343-5657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1439630-01Medicaid