# FLINT DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creekside Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407460975
- **Authorized official:** DR. WILLIAM ROBERT JENNINGS DDS DDS (OWNER/SOLE MEMBER)
- **Authorized official phone:** (940) 206-8956

## Contact information

- **Practice address:** 17159 FM 2493, FLINT, TX 75762-8331
- **Practice address phone:** (064) 903-8946
- **Mailing address:** 4324 LAZY CREEK DR, TYLER, TX 75707-1554
- **Mailing address phone:** (903) 330-2509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/02/2020
- **Last updated:** 09/02/2020