Provider Demographics
NPI:1689012262
Name:AFFORDABLE DENTURES-AMERICAN FORK, P. C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES-AMERICAN FORK, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-756-7676
Mailing Address - Street 1:484 N 950 W
Mailing Address - Street 2:SUITE C
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3540
Mailing Address - Country:US
Mailing Address - Phone:801-756-7676
Mailing Address - Fax:
Practice Address - Street 1:484 N 950 W
Practice Address - Street 2:SUITE C
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-3540
Practice Address - Country:US
Practice Address - Phone:801-756-7676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7827411-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty