Doctor Name: | DR. GARY LEE CREISHER |
NPI Number: | 1063729002 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S. |
License Number: | DEN3715 |
Business Practice Address: | 31 York St Kennebunk, ME - 040437152 |
Business Phone Number: | 2079852800 |
Business Fax Number: | 2079857185 |
Mailing Address: | 31 York St, KENNEBUNK |
State: | ME |
Postal Code: | 040437152 |
Phone Number: | 2079852800 |
Fax Number: | 2079857185 |
NPI Enumeration Date: | 09/13/2010 |
NPI Last Update Date: | 09/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DEN3715 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |