NPI | 1588058960 |
---|---|
Doing Business As | CREEKSTONE DENTAL |
Entity Type | Organization |
Authorized Contact | THOMAS R DICKSON President/Dentist 801-567-0343 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 264648) |
Enumeration Date | 2015-03-24 |
Last Update Date | 2015-03-24 |