Provider Demographics
NPI:1558547166
Name:CREECH, CYNTHIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:CREECH
Suffix:
Gender:F
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:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:BEN LOMOND
Mailing Address - State:CA
Mailing Address - Zip Code:95005-0847
Mailing Address - Country:US
Mailing Address - Phone:831-336-2261
Mailing Address - Fax:831-336-5600
Practice Address - Street 1:231 MAIN ST.
Practice Address - Street 2:
Practice Address - City:BEN LOMOND
Practice Address - State:CA
Practice Address - Zip Code:95005
Practice Address - Country:US
Practice Address - Phone:831-336-2261
Practice Address - Fax:831-336-5600
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist