Provider Demographics
NPI:1225324411
Name:AFFORDABLE DENTURES - FLORENCE II, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - FLORENCE II, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-764-6091
Mailing Address - Street 1:1603 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2152
Mailing Address - Country:US
Mailing Address - Phone:256-764-6091
Mailing Address - Fax:
Practice Address - Street 1:1603 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2152
Practice Address - Country:US
Practice Address - Phone:256-764-6091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty