Provider Demographics
NPI:1851877765
Name:AFFORDABLE DENTURES & IMPLANTS - FORT PAYNE, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - FORT PAYNE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-845-3050
Mailing Address - Street 1:1201 BRIARWOOD AVE SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-8473
Mailing Address - Country:US
Mailing Address - Phone:256-845-3050
Mailing Address - Fax:
Practice Address - Street 1:1201 BRIARWOOD AVE SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-8473
Practice Address - Country:US
Practice Address - Phone:256-845-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty