Provider Demographics
NPI:1780649244
Name:DENTAL CARE ASSOCIATES
Entity Type:Organization
Organization Name:DENTAL CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:A
Authorized Official - Last Name:BONNEVIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-297-1644
Mailing Address - Street 1:2145 LANCELOT DR
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-3093
Mailing Address - Country:US
Mailing Address - Phone:716-297-1644
Mailing Address - Fax:716-297-9855
Practice Address - Street 1:2145 LANCELOT DR
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-3093
Practice Address - Country:US
Practice Address - Phone:716-297-1644
Practice Address - Fax:716-297-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02207409Medicaid
NY01133944Medicaid
NY02656471Medicaid
NY00645318Medicaid
NY00644380Medicaid
NY00826215Medicaid