Provider Demographics
NPI:1497888770
Name:C-DENTAL GROUP P.A.
Entity Type:Organization
Organization Name:C-DENTAL GROUP P.A.
Other - Org Name:ALLCARE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-524-7554
Mailing Address - Street 1:515 WESTHEIMER RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-2931
Mailing Address - Country:US
Mailing Address - Phone:713-524-7554
Mailing Address - Fax:713-526-4780
Practice Address - Street 1:515 WESTHEIMER RD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2931
Practice Address - Country:US
Practice Address - Phone:713-524-7554
Practice Address - Fax:713-526-4780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QD0000X261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17894-01OtherTEXAS CHIP PROGRAM