Provider Demographics
NPI:1801277496
Name:ANCAR INC
Entity type:Organization
Organization Name:ANCAR INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:CAMERINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-632-7778
Mailing Address - Street 1:5731 SILVERSTONE TER
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3575
Mailing Address - Country:US
Mailing Address - Phone:719-632-7778
Mailing Address - Fax:719-632-1910
Practice Address - Street 1:5731 SILVERSTONE TER
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3575
Practice Address - Country:US
Practice Address - Phone:719-632-7778
Practice Address - Fax:719-632-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty