Provider Demographics
NPI:1326818220
Name:AFFORDABLE DENTURES & IMPLANTS - SPRINGFIELD IV, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - SPRINGFIELD IV, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-747-9830
Mailing Address - Street 1:3314 GATEWAY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-1054
Mailing Address - Country:US
Mailing Address - Phone:541-747-9830
Mailing Address - Fax:
Practice Address - Street 1:3314 GATEWAY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1054
Practice Address - Country:US
Practice Address - Phone:541-747-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty