Provider Demographics
NPI:1235708124
Name:AFFORDABLE DENTURES & IMPLANTS - NY, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - NY, P.C.
Other - Org Name:AFFORDABLE DENTURES & IMPLANTS - CICERO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-214-0004
Mailing Address - Street 1:5663 E CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-8907
Mailing Address - Country:US
Mailing Address - Phone:315-214-0004
Mailing Address - Fax:
Practice Address - Street 1:5663 E CIRCLE DR
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-8907
Practice Address - Country:US
Practice Address - Phone:315-214-0004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty