Provider Demographics
NPI:1073295721
Name:AFFORDABLE DENTURES & IMPLANTS - FLORIDA II, PLLC
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - FLORIDA II, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-970-4783
Mailing Address - Street 1:1293 S STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4021
Mailing Address - Country:US
Mailing Address - Phone:954-970-4783
Mailing Address - Fax:
Practice Address - Street 1:1293 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-4021
Practice Address - Country:US
Practice Address - Phone:954-970-4783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty