| Creekside Dental | |
|
1501 S 40th Ave Yakima WA 98908-3963 | |
| (509) 577-8277 | |
| (509) 573-4858 |
| Full Name | Creekside Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1501 S 40th Ave, Yakima, Washington |
| Authorized Official Name and Position | Leslee R Thysell (OFFICE MANAGER) |
| Authorized Official Contact | 5095778277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Dental 1501 S 40th Ave Yakima WA 98908-3963 Ph: (509) 577-8277 | Creekside Dental 1501 S 40th Ave Yakima WA 98908-3963 Ph: (509) 577-8277 |
| NPI Number | 1811085665 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 03/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811085665 | NPI | - | NPPES |
| 5020037 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 601472726 (Washington) | Primary |
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