Provider Demographics
NPI:1275288185
Name:DENTAL CARE OF VANDYKE INC
Entity type:Organization
Organization Name:DENTAL CARE OF VANDYKE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ISHWER
Authorized Official - Middle Name:
Authorized Official - Last Name:REHSI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-528-8701
Mailing Address - Street 1:18930 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4908
Mailing Address - Country:US
Mailing Address - Phone:813-528-8701
Mailing Address - Fax:813-528-8703
Practice Address - Street 1:18930 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4908
Practice Address - Country:US
Practice Address - Phone:813-528-8701
Practice Address - Fax:813-528-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental