Provider Demographics
NPI:1740535582
Name:CREIGHTON, DENISE COLON (RDH,BA)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:COLON
Last Name:CREIGHTON
Suffix:
Gender:F
Credentials:RDH,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CALLE GUARD
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1304
Mailing Address - Country:US
Mailing Address - Phone:787-890-8477
Mailing Address - Fax:787-890-8481
Practice Address - Street 1:260 CALLE GUARD
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-1304
Practice Address - Country:US
Practice Address - Phone:787-890-8477
Practice Address - Fax:787-890-8481
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16684124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist