Provider Demographics
NPI:1871850222
Name:AFFORDABLE DENTURES - ROCK HILL, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - ROCK HILL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSAF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-227-5481
Mailing Address - Street 1:7318 ARGUS DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7318 ARGUS DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5864
Practice Address - Country:US
Practice Address - Phone:815-227-5481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0278441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty