Provider Demographics
NPI:1174873079
Name:MAURY H KRYSTEL DDS PA
Entity type:Organization
Organization Name:MAURY H KRYSTEL DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:MAURY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:KRYSTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-575-7900
Mailing Address - Street 1:9899 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-3010
Mailing Address - Country:US
Mailing Address - Phone:727-575-7900
Mailing Address - Fax:727-258-4804
Practice Address - Street 1:9899 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-3010
Practice Address - Country:US
Practice Address - Phone:727-575-7900
Practice Address - Fax:727-258-4804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6416332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty