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Organization

CREEKSIDE DENTAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HOANG RICHARD NGHIEM DDS (PRESIDENT)
(817) 417-0655
Entity
Organization

Contact information

Practice address
2356 SE GREEN OAKS BLVD, STE 192, ARLINGTON, TX 76018-0924
(817) 417-0655
(817) 468-8834
Mailing address
2356 SE GREEN OAKS BLVD, STE 192, ARLINGTON, TX 76018-0924
(817) 417-0655
(817) 468-8834

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16733
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104717
UNITED CONCORDIA PROV. #
PA
01
23461
UNITED HEALTHCARE #
UT
01
84D494
BLUE CROSS #
TX
Enumeration date
03/07/2007
Last updated
08/22/2020
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