Organization
CREEKSIDE DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNDI SIMMONS (PRACTICE MANAGER)
(770) 466-0474
Entity
Organization
Contact information
Practice address
3238 KRISAM CREEK DR, LOGANVILLE, GA 30052-7942
(770) 466-0474
(770) 466-3894
Mailing address
3238 KRISAM CREEK DR, LOGANVILLE, GA 30052-7942
(770) 466-0474
(770) 466-3894
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
GA8776
GA
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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