Provider Demographics
NPI:1194360024
Name:AFFORDABLE DENTURES & IMPLANTS - ORANGEBURG, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - ORANGEBURG, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-534-4350
Mailing Address - Street 1:1532 SAINT MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2437
Mailing Address - Country:US
Mailing Address - Phone:803-534-4350
Mailing Address - Fax:
Practice Address - Street 1:1532 SAINT MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2437
Practice Address - Country:US
Practice Address - Phone:803-534-4350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty