| NPI | 1811422942 |
|---|---|
| Doing Business As | INDIAN CREEK DENTAL |
| Entity Type | Organization |
| Authorized Contact | RICHARD SHAD HATTAWAY Owner 972-836-8653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30158) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |