Provider Demographics
NPI:1184118226
Name:AFFORDABLE DENTURES & IMPLANTS - LENOIR CITY, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - LENOIR CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:865-986-3234
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-0938
Mailing Address - Country:US
Mailing Address - Phone:865-986-3234
Mailing Address - Fax:
Practice Address - Street 1:16374 HOTCHKISS VALLEY RD E
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-6064
Practice Address - Country:US
Practice Address - Phone:865-986-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty