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NPI Code Detail

MEDICARE: C AND T DENTAL LABORATORY, LLC

MEDICARE: C AND T DENTAL LABORATORY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1292200000XDental Laboratory

General Provider Information

NPI Number : 1053865766
Entity Type Code : Organization
Provider Name (Legal Business Name) : C AND T DENTAL LABORATORY, LLC
Provider Business Mailing Address
First Line : 2101 S JONES BLVD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3133
Country : US
Telephone Number : 702-259-9990
Fax Number : 702-259-6045
Provider Business Practice Location Address
First Line : 2101 S JONES BLVD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3133
Country : US
Telephone Number : 702-259-9990
Fax Number : 702-259-6045
Authorized Official
Title or Position : RCM DIRECTOR
Name : ROBIN FOBBS WELCH
Credential :
Telephone Number : 702-522-3324
Provider Enumeration Date : 08/10/2016
Last Update Date : 09/02/2025

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