MEDICARE: CREEKVIEW FAMILY DENTISTRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	D6952	AZ

General Provider Information

NPI Number	:	1477731834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREEKVIEW FAMILY DENTISTRY LLC

Provider Business Mailing Address
First Line	:	936 E WILLIAMS FIELD RD
Second Line	:	SUITE 102
City	:	GILBERT
State	:	AZ
Zip	:	85295-4881
Country	:	US
Telephone Number	:	480-926-0776
Fax Number	:	480-899-9689

Provider Business Practice Location Address
First Line	:	936 E WILLIAMS FIELD RD
Second Line	:	SUITE 102
City	:	GILBERT
State	:	AZ
Zip	:	85295-4881
Country	:	US
Telephone Number	:	480-926-0776
Fax Number	:	480-899-9689

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. NATHAN JOHN SAYDYK
Credential	:	DDS
Telephone Number	:	480-717-9466

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	01/19/2021

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Directions to “CREEKVIEW FAMILY DENTISTRY LLC ” Practice Location

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