Individual
DIANE J CREEDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1434 PORTER STREET, FORT DETRICK, MD 21702
(301) 619-7675
Mailing address
1434 PORTER STREET, FORT DETRICK, MD 21702
(301) 619-7675
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH15181
FL
Other
Enumeration date
06/14/2016
Last updated
06/07/2022
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