Provider Demographics
NPI:1275216541
Name:AFFORDABLE DENTURES & IMPLANTS - CHRISTIANSBURG, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - CHRISTIANSBURG, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-288-4200
Mailing Address - Street 1:175 CONSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1151
Mailing Address - Country:US
Mailing Address - Phone:540-288-4200
Mailing Address - Fax:
Practice Address - Street 1:175 CONSTON AVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1151
Practice Address - Country:US
Practice Address - Phone:540-288-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty