Provider Demographics
NPI:1992740500
Name:CW DENTAL, INC
Entity type:Organization
Organization Name:CW DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:V
Authorized Official - Last Name:CRUPI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:941-373-3904
Mailing Address - Street 1:5561 BROADCAST CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8472
Mailing Address - Country:US
Mailing Address - Phone:941-373-3904
Mailing Address - Fax:941-907-0565
Practice Address - Street 1:5561 BROADCAST CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-8472
Practice Address - Country:US
Practice Address - Phone:941-373-3904
Practice Address - Fax:941-907-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty