Provider Demographics
NPI:1760784888
Name:AFFORDABLE DENTURES - KALAMAZOO, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - KALAMAZOO, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:269-382-0810
Mailing Address - Street 1:5017 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1001
Mailing Address - Country:US
Mailing Address - Phone:269-382-0810
Mailing Address - Fax:269-382-0620
Practice Address - Street 1:5017 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1001
Practice Address - Country:US
Practice Address - Phone:269-382-0810
Practice Address - Fax:269-382-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty