| Creekstone Dental | |
|
714 E Fort Union Blvd Midvale UT 84047-2347 | |
| (801) 567-0343 | |
| (801) 566-5725 |
| Full Name | Creekstone Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 714 E Fort Union Blvd, Midvale, Utah |
| Authorized Official Name and Position | Thomas R Dickson (PRESIDENT/DENTIST) |
| Authorized Official Contact | 8015670343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekstone Dental 714 E Fort Union Blvd Midvale UT 84047-2347 Ph: (801) 567-0343 | Creekstone Dental 714 E Fort Union Blvd Midvale UT 84047-2347 Ph: (801) 567-0343 |
| NPI Number | 1588058960 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 03/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588058960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 264648 (Utah) | Primary |
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