Provider Demographics
NPI:1053865766
Name:C AND T DENTAL LABORATORY
Entity Type:Organization
Organization Name:C AND T DENTAL LABORATORY
Other - Org Name:RELIABLE DENTAL LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-522-2028
Mailing Address - Street 1:2101 S JONES BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3133
Mailing Address - Country:US
Mailing Address - Phone:702-259-9990
Mailing Address - Fax:702-259-6045
Practice Address - Street 1:2101 S JONES BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3133
Practice Address - Country:US
Practice Address - Phone:702-259-9990
Practice Address - Fax:702-259-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory