Provider Demographics
NPI:1346750619
Name:AFFORDABLE DENTURES & IMPLANTS - TENNESSEE, PLLC
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - TENNESSEE, PLLC
Other - Org Name:DDS DENTURES PLUS IMPLANT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-733-8551
Mailing Address - Street 1:5226 AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5226 AIRLINE RD,
Practice Address - Street 2:121
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002
Practice Address - Country:US
Practice Address - Phone:901-329-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN97321223G0001X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty