Provider Demographics
NPI:1902512387
Name:COMMUNITY DENTAL CONNECTIONS, INC.
Entity Type:Organization
Organization Name:COMMUNITY DENTAL CONNECTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANCETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANGUILDER
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:775-224-4270
Mailing Address - Street 1:4331 ROUNDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-1606
Mailing Address - Country:US
Mailing Address - Phone:775-224-4323
Mailing Address - Fax:
Practice Address - Street 1:4331 ROUNDSTONE DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-1606
Practice Address - Country:US
Practice Address - Phone:775-224-4323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental