Provider Demographics
NPI:1093952293
Name:INTERNATIONAL DENTAL CARE INC.
Entity Type:Organization
Organization Name:INTERNATIONAL DENTAL CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-234-8998
Mailing Address - Street 1:2108 18TH ST NW STE 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1891
Mailing Address - Country:US
Mailing Address - Phone:202-234-8998
Mailing Address - Fax:
Practice Address - Street 1:2108 18TH ST NW STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1891
Practice Address - Country:US
Practice Address - Phone:202-234-8998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-10
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty