| NPI | 1306629050 |
|---|---|
| Doing Business As | EAGLE CREEK DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | RYAN GLENN WHITE Managing Member 270-339-4583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |