| NPI | 1225470909 |
|---|---|
| Doing Business As | CREEK ROAD DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | AMY E. FLORANCE DETHORN Owner 801-566-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 8628346) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |