| NPI | 1811085665 |
|---|---|
| Doing Business As | CREEKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LESLEE R THYSELL Office Manager 509-577-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 601472726) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2011-03-29 |