| NPI | 1831528447 |
|---|---|
| Doing Business As | CREEKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | PATRICK J FOY Owner 952-938-2740 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 9089) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2015-11-06 |