| NPI | 1790394138 |
|---|---|
| Doing Business As | CREEKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | CARY LACOUTURE Owner 303-841-0549 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |