Organization
PACKARD, PACKARD & PACKARD, PS
Active
Other names
Creekside Dental
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEE R THYSELL (OFFICE MANAGER)
(509) 577-8277
Entity
Organization
Contact information
Practice address
1501 S 40TH AVE, YAKIMA, WA 98908-3963
(509) 577-8277
(509) 573-4858
Mailing address
1501 S 40TH AVE, YAKIMA, WA 98908-3963
(509) 577-8277
(509) 573-4858
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
601472726
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5020037
—
WA
Enumeration date
10/10/2006
Last updated
03/29/2011
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