Provider Demographics
NPI:1972009975
Name:AFFORDABLE DENTURES & IMPLANTS - JEFFERSONVILLE, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - JEFFERSONVILLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:812-284-2206
Mailing Address - Street 1:2760 JEFFERSON CENTRE WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-8266
Mailing Address - Country:US
Mailing Address - Phone:812-284-2206
Mailing Address - Fax:
Practice Address - Street 1:2760 JEFFERSON CENTRE WAY STE 2
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-8266
Practice Address - Country:US
Practice Address - Phone:812-284-2206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty