Provider Demographics
NPI:1083438592
Name:C & K DENTAL
Entity type:Organization
Organization Name:C & K DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALIE
Authorized Official - Middle Name:NGA
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-237-2291
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-0236
Mailing Address - Country:US
Mailing Address - Phone:570-726-4988
Mailing Address - Fax:
Practice Address - Street 1:110 RADNOR RD STE 201
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7987
Practice Address - Country:US
Practice Address - Phone:814-237-2291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental