Provider Demographics
NPI:1639529977
Name:AFFORDABLE DENTURES - DULUTH, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - DULUTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:BCHD
Authorized Official - Phone:218-279-9985
Mailing Address - Street 1:4310 MENARD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-1564
Mailing Address - Country:US
Mailing Address - Phone:218-279-9985
Mailing Address - Fax:
Practice Address - Street 1:4310 MENARD DR STE 300
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-1564
Practice Address - Country:US
Practice Address - Phone:218-279-9985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty