Provider Demographics
NPI:1891667101
Name:CC APPLE DENTAL CENTER INC
Entity type:Organization
Organization Name:CC APPLE DENTAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAHLKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-993-9551
Mailing Address - Street 1:1220 AIRLINE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-3479
Mailing Address - Country:US
Mailing Address - Phone:361-993-9551
Mailing Address - Fax:361-991-7887
Practice Address - Street 1:1220 AIRLINE RD STE 210
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-3479
Practice Address - Country:US
Practice Address - Phone:361-993-9551
Practice Address - Fax:361-991-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty