# CREEKSIDE DENTAL

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

## Provider details

- **NPI number:** 1568917888
- **Authorized official:** DR. DAVID LEWIS HANSON DDS (DENTIST/OWNER)
- **Authorized official phone:** (360) 695-1515

## Contact information

- **Practice address:** 910 NE TENNEY RD STE 117, VANCOUVER, WA 98685-2838
- **Practice address phone:** (360) 695-1515
- **Practice address fax:** (360) 694-8449
- **Mailing address:** 910 NE TENNEY RD STE 117, VANCOUVER, WA 98685-2838
- **Mailing address phone:** (360) 695-1515
- **Mailing address fax:** (360) 694-8449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6279 | WA | Yes |

## Other

- **Enumeration date:** 08/16/2016
- **Last updated:** 08/16/2016