Provider Demographics
NPI:1902948847
Name:CREAGER, CATHY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:S
Last Name:CREAGER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 E FREEWAY DR SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-5916
Mailing Address - Country:US
Mailing Address - Phone:770-922-2521
Mailing Address - Fax:770-922-0263
Practice Address - Street 1:992 E FREEWAY DR SE
Practice Address - Street 2:SUITE B
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5916
Practice Address - Country:US
Practice Address - Phone:770-922-2521
Practice Address - Fax:770-922-0263
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0104251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice