Pine Creek Dental, Pllc

NPI #1639549454 in Tyler, Texas

Provider Information

NPI Number: 1639549454
Entity Type: Organization
Organization Name: Pine Creek Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 6, 2015
Last Updated: Jan 6, 2016

Practice Location

Address: 7925 S BROADWAY AVE STE 300
City: Tyler
State: Texas
ZIP Code: 75703-5227
Phone: (903) 561-2232

Authorized Official

Name: DR. CHRISTOPHER TUTT, DDS
Title: DENTIST
Phone: (903) 561-2232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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