Provider Demographics
NPI:1356089072
Name:AFFORDABLE DENTURES & IMPLANTS - MIDWEST CITY, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - MIDWEST CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MENG-JU
Authorized Official - Middle Name:
Authorized Official - Last Name:DU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:405-672-0214
Mailing Address - Street 1:5301 MAIN ST STE 111
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-5507
Mailing Address - Country:US
Mailing Address - Phone:405-672-0214
Mailing Address - Fax:
Practice Address - Street 1:5301 MAIN ST STE 111
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-5507
Practice Address - Country:US
Practice Address - Phone:405-672-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty