Provider Demographics
NPI:1275823197
Name:AFFORDABLE DENTISTRY PA
Entity Type:Organization
Organization Name:AFFORDABLE DENTISTRY PA
Other - Org Name:SHANDON FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVANG
Authorized Official - Middle Name:H
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-447-6009
Mailing Address - Street 1:2329 DEVINE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2431
Mailing Address - Country:US
Mailing Address - Phone:803-447-6009
Mailing Address - Fax:
Practice Address - Street 1:2329 DEVINE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2431
Practice Address - Country:US
Practice Address - Phone:803-447-6009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4644261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental