Provider Demographics
NPI:1013375013
Name:AFFORDABLE DENTURES & IMPLANTS - OKLAHOMA CITY, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - OKLAHOMA CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-948-2637
Mailing Address - Street 1:3627 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4405
Mailing Address - Country:US
Mailing Address - Phone:405-948-2637
Mailing Address - Fax:
Practice Address - Street 1:3627 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4405
Practice Address - Country:US
Practice Address - Phone:405-948-2637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty