| Creek Capital Stansbury Park Llc | |
|
220 Millpond Ste 107 Stansbury Park UT 84074-9760 | |
| (435) 843-5437 | |
| Not Available |
| Full Name | Creek Capital Stansbury Park Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 220 Millpond Ste 107, Stansbury Park, Utah |
| Authorized Official Name and Position | Marci Nicol (COO) |
| Authorized Official Contact | 8013127122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creek Capital Stansbury Park Llc 678 E Vine St Murray UT 84107-5546 Ph: (801) 312-7122 | Creek Capital Stansbury Park Llc 220 Millpond Ste 107 Stansbury Park UT 84074-9760 Ph: (435) 843-5437 |
| NPI Number | 1407374341 |
|---|---|
| Provider Enumeration Date | 08/30/2017 |
| Last Update Date | 08/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407374341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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