| NPI | 1801082656 |
|---|---|
| Doing Business As | CREEKSIDE COSMETIC AND FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | REED ELLIS JOHNSON Pres Owner 317-839-3502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12009024) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-14 |