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General NPI Number Information
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NPI Number | 1376493817
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Entity Type | Organization
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Legal Business Name | CREEKSIDE FAMILY DENTAL, P.C.
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 4020 S 700 E STE 1
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-7900
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Country | US
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Telephone | 801-263-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 S 700 E STE 1
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-7900
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Country | US
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Telephone | 801-263-2633
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CECILIA SERRATO
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Credential | DMD
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Telephone | 385-259-3880
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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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