| NPI | 1265839831 |
|---|---|
| Doing Business As | PACKWOOD CREEK DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | BEVAN S FAREID Owner 559-732-1953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2022-03-08 |