Creason, Kennard William

Creason, Kennard William is an individual health care provider with primary practice located at 333 A Jackson , Grand Haven MI 49417. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Creason, Kennard William can be contacted via phone (616) 842-0822.

Contact Information

Primary practice address
333 A Jackson Grand Haven MI 49417
Phone: (616) 842-0822
Fax: (616) 842-0955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2901011283 Michigan

Profile Details

NPI number 1386717098
LBN Legal business name Creason, Kennard William
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386717098 NPPES
Michigan MEDICAID 4042439

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