Provider Demographics
NPI:1073320487
Name:AFFORDABLE DENTURES & IMPLANTS - LAKELAND, P.A.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - LAKELAND, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEPES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:863-701-7404
Mailing Address - Street 1:3615 S FLORIDA AVE STE 1230
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4808
Mailing Address - Country:US
Mailing Address - Phone:863-701-7404
Mailing Address - Fax:
Practice Address - Street 1:3615 S FLORIDA AVE STE 1230
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4808
Practice Address - Country:US
Practice Address - Phone:863-701-7404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty