| NPI | 1598398653 |
|---|---|
| Doing Business As | CREEKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEFF COHEN COO 704-246-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2021-05-21 |