Provider Demographics
NPI:1720581044
Name:CANDDS DENTAL COMPANY PLLC
Entity Type:Organization
Organization Name:CANDDS DENTAL COMPANY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-291-0800
Mailing Address - Street 1:145 W FM 1382 STE 100
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5804
Mailing Address - Country:US
Mailing Address - Phone:972-291-0800
Mailing Address - Fax:972-291-0801
Practice Address - Street 1:145 W FM 1382 STE 100
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5804
Practice Address - Country:US
Practice Address - Phone:972-291-0800
Practice Address - Fax:972-291-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114273026OtherNPI TYPE 1