Provider Demographics
NPI:1760082648
Name:AFFORDABLE DENTURES & IMPLANTS - CLEARWATER II, P.A.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - CLEARWATER II, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEDESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADURO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-669-3854
Mailing Address - Street 1:26258 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-4506
Mailing Address - Country:US
Mailing Address - Phone:727-669-3854
Mailing Address - Fax:
Practice Address - Street 1:26258 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4506
Practice Address - Country:US
Practice Address - Phone:727-669-3854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty