Creek Capital Park City LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CREEK CAPITAL PARK CITY LLC

Practice address

1901 Prospector Ave Ste 26
Park City, UT 84060-7208

Phone

(435) 649-5001

NPI assigned

Aug 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marci Nicol

Title

Coo

Phone

(801) 312-7122

Specialties & licenses 1

Addresses

Other names 1

• Burg Children's Dentistry & Orthodontics- Park City Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1043738974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 E VINE ST STE 10",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075500",
            "telephone_number": "801-918-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 PROSPECTOR AVE STE 26",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607208",
            "telephone_number": "435-649-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK CAPITAL PARK CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "801-312-7122"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burg Children's Dentistry & Orthodontics- Park City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teague Richard Cowley
• Scott Cox, RPH
• Brittany Elizabeth Coyle, M.A. BCBA
• Ryan Patrick Coyle, OD
• Leslie Clark Crabb
• Geoffrey Matthew Crockett, MD
• Marguerite Crosby, RD
• Stephanie Croteau, PHARMD
• Michelle R Croyle, PA-C
• Kirsten Cummings, CMHC

• Pediatric Dentistry in Park City, UT
• Providers in Park City, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.