# EMERALD DENTAL P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386308492
- **Authorized official:** CREED CARDON DDS (OWNER)
- **Authorized official phone:** (918) 998-0996

## Contact information

- **Practice address:** 1629 POYNTZ AVE, MANHATTAN, KS 66502-4148
- **Practice address phone:** (785) 776-1771
- **Mailing address:** 400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
- **Mailing address phone:** (918) 998-0996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2021
- **Last updated:** 10/25/2021