Provider Demographics
NPI:1326639188
Name:CATAWBA CREEK DENTAL
Entity Type:Organization
Organization Name:CATAWBA CREEK DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARRIKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-403-9136
Mailing Address - Street 1:1309 UNION RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-5562
Mailing Address - Country:US
Mailing Address - Phone:704-991-7227
Mailing Address - Fax:704-991-7229
Practice Address - Street 1:1309 UNION RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5562
Practice Address - Country:US
Practice Address - Phone:704-991-7227
Practice Address - Fax:704-991-7229
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOORESVILLE FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental