Provider Demographics
NPI:1154333995
Name:CREAGER, WARD E (DMD)
Entity Type:Individual
Prefix:MR
First Name:WARD
Middle Name:E
Last Name:CREAGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 N WASHINGTON BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-3457
Mailing Address - Country:US
Mailing Address - Phone:801-782-4233
Mailing Address - Fax:801-782-1734
Practice Address - Street 1:1690 N WASHINGTON BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-3457
Practice Address - Country:US
Practice Address - Phone:801-782-4233
Practice Address - Fax:801-782-1734
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5656476122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT56564769902001OtherBXBS
78191OtherPEHP-CHIP