Provider Demographics
NPI:1790465037
Name:AFFORDABLE DENTURES & IMPLANTS - FREDERICKSBURG, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - FREDERICKSBURG, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MESFIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELLEKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-322-1448
Mailing Address - Street 1:1660 CARL D SILVER PKWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4924
Mailing Address - Country:US
Mailing Address - Phone:540-322-1448
Mailing Address - Fax:
Practice Address - Street 1:1660 CARL D SILVER PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4924
Practice Address - Country:US
Practice Address - Phone:540-322-1448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty