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General NPI Number Information
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NPI Number | 1023314747
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Entity Type | Organization
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Legal Business Name | CREEK 75 DENTAL GROUP PC
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 101 W SPRING CREEK PKWY SUITE 732
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City | PLANO
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State | TX
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Zip | 75023-4624
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Country | US
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Telephone | 214-415-9096
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W SPRING CREEK PKWY SUITE 732
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City | PLANO
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State | TX
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Zip | 75023-4624
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Country | US
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Telephone | 214-415-9096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BORHAN PAJOOHI
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Credential | DMD
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Telephone | 214-415-9096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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