# CREEK CAPITAL PARK CITY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Burg Children's Dentistry & Orthodontics- Park City
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043738974
- **Authorized official:** MARCI NICOL (COO)
- **Authorized official phone:** (801) 312-7122

## Contact information

- **Practice address:** 1901 PROSPECTOR AVE STE 26, PARK CITY, UT 84060-7208
- **Practice address phone:** (435) 649-5001
- **Mailing address:** 678 E VINE ST STE 10, MURRAY, UT 84107-5500
- **Mailing address phone:** (801) 918-4135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2017
- **Last updated:** 08/30/2017