NPI 1396459376 · live from the CMS NPI Registry
Creekside Dental, LLC.
Dentist in Newark, DE. National Provider Identifier 1396459376, active.
NPI record
| NPI | 1396459376 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 414 Capitol Trl, Newark, DE 19711 |
| Practice phone | 302-738-5766 |
| Mailing address | 1250 Peoples Plz, Newark, DE 19702 |
| Enumerated | January 13, 2023 |
| Last updated | January 13, 2023 |
| Authorized official | Kellie Cernobyl, Chief Operating Officer |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.