Provider Demographics
NPI:1689825796
Name:NEDELTCHEV DENTAL CORPORATION
Entity Type:Organization
Organization Name:NEDELTCHEV DENTAL CORPORATION
Other - Org Name:MERCY PLAZA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMEN
Authorized Official - Middle Name:IVANOV
Authorized Official - Last Name:NEDELTCHEV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-663-0109
Mailing Address - Street 1:500 OLD RIVER RD STE 225
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9508
Mailing Address - Country:US
Mailing Address - Phone:661-663-0109
Mailing Address - Fax:661-663-9810
Practice Address - Street 1:500 OLD RIVER RD STE 225
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9508
Practice Address - Country:US
Practice Address - Phone:661-663-0109
Practice Address - Fax:661-663-9810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental