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General NPI Number Information
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NPI Number | 1255198388
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Entity Type | Organization
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Legal Business Name | BIRCH TREE PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 22363 E DOMINGO RD STE 104
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-0353
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Country | US
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Telephone | 480-896-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 22363 E DOMINGO RD STE 104
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-0353
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Country | US
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Telephone | 480-896-7800
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JOSEPH CREECH III
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Credential | DMD
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Telephone | 480-896-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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