Provider Demographics
NPI:1740742428
Name:AFFORDABLE DENTURES & IMPLANTS - KOKOMO, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - KOKOMO, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-596-9147
Mailing Address - Street 1:2220 E MARKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-6242
Mailing Address - Country:US
Mailing Address - Phone:317-596-9147
Mailing Address - Fax:
Practice Address - Street 1:2220 E MARKLAND AVE
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-6242
Practice Address - Country:US
Practice Address - Phone:317-596-9147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty