| NPI | 1689128746 |
|---|---|
| Doing Business As | CREEKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRIAN MOODY Owner 425-485-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010023) |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-06 |