Organization
CREEK CAPITAL BURG GENERAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCI NICOL (COO)
(801) 312-7122
Entity
Organization
Contact information
Practice address
678 E VINE ST STE 10, MURRAY, UT 84107-5500
(801) 268-1135
(801) 918-4135
Mailing address
678 E VINE ST STE 10, MURRAY, UT 84107-5500
(801) 918-4135
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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