Organization
CREEK DENTAL GROUP MEADOWBROOK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCI NICOL (VP)
(801) 312-1722
Entity
Organization
Contact information
Practice address
1148 E UT-193, LAYTON, UT 84040
(801) 383-0147
Mailing address
1275 E FORT UNION BLVD STE 100, MIDVALE, UT 84047-1890
(801) 918-4135
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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