Creekside Dental, INC.
Clinic/Center, Dental in Douglasville, GA. Organization (NPI-2).
NPI number1295561983
StatusActive
Last updated in NPPESSep 10, 2024
Details
- NPI
- 1295561983
- Entity type
- Organization (NPI-2)
- Legal business name
- Creekside Dental, INC.
- Organization subpart
- No
- Enumeration date
- Sep 10, 2024
- Certification date
- Sep 10, 2024
- Last updated
- Sep 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
4904 Timber Ridge Dr Ste 203Douglasville, GA 30135-1831
Phone 770-577-5727 · Fax 770-577-7542
Mailing address
4904 Timber Ridge Dr Ste 203Douglasville, GA 30135-1831
Phone 770-577-5727 · Fax 770-577-7542
Authorized official
Pamela Deas
Office Manager
7705775727
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