Provider Demographics
NPI:1407551872
Name:AFFORDABLE DENTURES & IMPLANTS - SMYRNA, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - SMYRNA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEALER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-610-3680
Mailing Address - Street 1:111 MOVIE ROW
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6532
Mailing Address - Country:US
Mailing Address - Phone:615-610-3680
Mailing Address - Fax:
Practice Address - Street 1:111 MOVIE ROW
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6532
Practice Address - Country:US
Practice Address - Phone:615-610-3680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty