Provider Demographics
NPI:1336356682
Name:CRESSMAN DENTAL GROUP, PC
Entity Type:Organization
Organization Name:CRESSMAN DENTAL GROUP, PC
Other - Org Name:GENTLE DENTAL SOUTH MARYLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:H
Authorized Official - Last Name:CRESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:800-684-6440
Mailing Address - Street 1:1101 SE TECH CENTER DR STE 195
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5511
Mailing Address - Country:US
Mailing Address - Phone:360-869-7645
Mailing Address - Fax:877-725-7443
Practice Address - Street 1:8880 S MARYLAND PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-6718
Practice Address - Country:US
Practice Address - Phone:702-270-8790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3516122300000X
NV6427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty