Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Custom Dental Care, PC

Organization Dentist · NPI 1932452893

Custom Dental Care, PC is a Dentist in Quincy, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3740 E Lake Ctr Ste B
Quincy, IL 62305-5805
Phone: (217) 214-4545
Fax: (217) 214-4546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019027406 (IL)

Record details

NPI number1932452893
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dennis Wagner — Owner/President · (217) 430-1429
NPI enumeratedOctober 17, 2012
Last updated in NPPESOctober 17, 2012
Mailing address3740 E Lake Ctr Ste B, Quincy, IL 62305-5805

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