Provider Demographics
NPI:1235905217
Name:AFFORDABLE DENTURES - MACEDONIA, BRIAN REDDITT, DMD, INC.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - MACEDONIA, BRIAN REDDITT, DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:REDDITT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-865-7541
Mailing Address - Street 1:8210 MACEDONIA COMMONS BLVD UNIT 6
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1862
Mailing Address - Country:US
Mailing Address - Phone:330-865-7541
Mailing Address - Fax:
Practice Address - Street 1:8210 MACEDONIA COMMONS BLVD UNIT 6
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1862
Practice Address - Country:US
Practice Address - Phone:330-865-7541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty