Provider Demographics
NPI:1265890925
Name:MCCANDLESS DENTAL CARE, PLLC
Entity type:Organization
Organization Name:MCCANDLESS DENTAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LUE
Authorized Official - Last Name:BENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-586-2955
Mailing Address - Street 1:5900 CORPORATE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-7005
Mailing Address - Country:US
Mailing Address - Phone:412-847-1420
Mailing Address - Fax:412-847-1422
Practice Address - Street 1:5900 CORPORATE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7005
Practice Address - Country:US
Practice Address - Phone:412-847-1420
Practice Address - Fax:412-847-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028902L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty