Provider Demographics
NPI:1568523827
Name:BASIC DENTAL CARE, LTD.
Entity Type:Organization
Organization Name:BASIC DENTAL CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:JORGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:775-323-0700
Mailing Address - Street 1:855 W 7TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2705
Mailing Address - Country:US
Mailing Address - Phone:775-323-0700
Mailing Address - Fax:775-323-0719
Practice Address - Street 1:855 W 7TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-2705
Practice Address - Country:US
Practice Address - Phone:775-323-0700
Practice Address - Fax:775-323-0719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV05651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty