Provider Demographics
NPI:1225188758
Name:STONECREEK ACQUISITIONS, LLC
Entity Type:Organization
Organization Name:STONECREEK ACQUISITIONS, LLC
Other - Org Name:STONECREEK DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-277-2424
Mailing Address - Street 1:2415 CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3140
Mailing Address - Country:US
Mailing Address - Phone:334-277-2424
Mailing Address - Fax:334-279-5151
Practice Address - Street 1:2415 CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3140
Practice Address - Country:US
Practice Address - Phone:334-277-2424
Practice Address - Fax:334-279-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty