Provider Demographics
NPI:1306219720
Name:AFFORDABLE DENTURES - SUN CITY, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - SUN CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIBERA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-977-5227
Mailing Address - Street 1:10918 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1018
Mailing Address - Country:US
Mailing Address - Phone:623-977-5227
Mailing Address - Fax:623-977-5229
Practice Address - Street 1:10918 W BELL RD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1018
Practice Address - Country:US
Practice Address - Phone:623-977-5227
Practice Address - Fax:623-977-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty