Custom Dental Care, P.C.

LBN: Custom Dental Care, P.C.
Custom Dental Care, P.C. is an health care organization with primary practice located at 3740 E Lake Ctr Ste B , Quincy IL 62305-5805. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Custom Dental Care, P.C. can be contacted via phone (217) 214-4545, or through Wagner, Dennis Ryan via phone (217) 430-1429.

Contact Information

Primary practice address
3740 E Lake Ctr Ste B Quincy IL 62305-5805
Phone: (217) 214-4545
Fax: (217) 214-4546
Website:
Map and Directions
Authorized official contact:
Name: Wagner, Dennis Ryan Doctor of Dental Medicine (DMD)
Phone: (217) 430-1429

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019027406 Illinois

Profile Details

NPI number 1932452893
LBN Legal business name Custom Dental Care, P.C.
DBA Doing business as
Authorized official Wagner, Dennis Ryan Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2012
Last updated Oct 17th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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