Provider Demographics
NPI:1144913013
Name:CREECH, TYSON HARDY II (DDS)
Entity type:Individual
Prefix:DR
First Name:TYSON
Middle Name:HARDY
Last Name:CREECH
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MARIETTA WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6786
Mailing Address - Country:US
Mailing Address - Phone:252-361-5544
Mailing Address - Fax:
Practice Address - Street 1:201 MARIETTA WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-6786
Practice Address - Country:US
Practice Address - Phone:252-361-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist