Provider Demographics
NPI:1952504904
Name:C. VANCE DENNING DDS PA
Entity Type:Organization
Organization Name:C. VANCE DENNING DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:VANCE
Authorized Official - Last Name:DENNING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-776-3332
Mailing Address - Street 1:PO BOX 1128
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330
Mailing Address - Country:US
Mailing Address - Phone:919-776-3332
Mailing Address - Fax:919-708-6965
Practice Address - Street 1:207 GORDON ST.
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330
Practice Address - Country:US
Practice Address - Phone:919-776-3332
Practice Address - Fax:919-708-6965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC36661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8992101Medicaid