Provider Demographics
NPI:1922815513
Name:DELHI TOWNSHIP DENTAL LLC
Entity type:Organization
Organization Name:DELHI TOWNSHIP DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MALENFANT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-968-7625
Mailing Address - Street 1:6598 WYNDWATCH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-5266
Mailing Address - Country:US
Mailing Address - Phone:720-822-3502
Mailing Address - Fax:
Practice Address - Street 1:672 NEEB RD STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-4619
Practice Address - Country:US
Practice Address - Phone:513-451-5399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental