Provider Demographics
NPI:1609355692
Name:AFFORDABLE DENTURES & IMPLANTS-MERRILLVILLE, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS-MERRILLVILLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZASSO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-769-8188
Mailing Address - Street 1:1613 E 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5737
Mailing Address - Country:US
Mailing Address - Phone:219-769-8188
Mailing Address - Fax:219-769-8802
Practice Address - Street 1:1613 E 80TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5737
Practice Address - Country:US
Practice Address - Phone:219-769-8188
Practice Address - Fax:219-769-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty