Provider Demographics
NPI:1780182170
Name:AFFORDABLE DENTURES & IMPLANTS - MCCALLA P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - MCCALLA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:205-477-5950
Mailing Address - Street 1:4760 EASTERN VALLEY RD STE 136
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-3458
Mailing Address - Country:US
Mailing Address - Phone:205-477-5950
Mailing Address - Fax:
Practice Address - Street 1:4760 EASTERN VALLEY RD STE 136
Practice Address - Street 2:
Practice Address - City:MC CALLA
Practice Address - State:AL
Practice Address - Zip Code:35111-3458
Practice Address - Country:US
Practice Address - Phone:205-477-5950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty