Provider Demographics
NPI:1932368123
Name:ROCKY CREEK DENTAL CARE
Entity type:Organization
Organization Name:ROCKY CREEK DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK
Authorized Official - Prefix:
Authorized Official - First Name:MAGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-403-7625
Mailing Address - Street 1:7270 HIGHWAY 6
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4690
Mailing Address - Country:US
Mailing Address - Phone:281-403-7625
Mailing Address - Fax:
Practice Address - Street 1:7270 HIGHWAY 6
Practice Address - Street 2:SUITE 300
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4690
Practice Address - Country:US
Practice Address - Phone:281-403-7625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty