Provider Demographics
NPI:1134283484
Name:CREASON, PAUL KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KEVIN
Last Name:CREASON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 S BEECHTREE ST STE 6B
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2385
Mailing Address - Country:US
Mailing Address - Phone:616-844-6900
Mailing Address - Fax:616-935-9939
Practice Address - Street 1:921 S BEECHTREE ST STE 6B
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2385
Practice Address - Country:US
Practice Address - Phone:616-844-6900
Practice Address - Fax:616-935-9939
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010147021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice