Provider Demographics
NPI:1255801379
Name:AFFORDABLE DENTURES & IMPLANTS - EVANSVILLE, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - EVANSVILLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-692-1273
Mailing Address - Street 1:619 N BURKHARDT RD STE A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7296
Mailing Address - Country:US
Mailing Address - Phone:360-692-1273
Mailing Address - Fax:
Practice Address - Street 1:619 N BURKHARDT RD STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7296
Practice Address - Country:US
Practice Address - Phone:360-692-1273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-01
Last Update Date:2018-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty