Provider Demographics
NPI:1386452720
Name:AFFORDABLE DENTURES & IMPLANTS - BEND II, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - BEND II, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-797-6935
Mailing Address - Street 1:63455 N HIGHWAY 97 STE 13
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-5724
Mailing Address - Country:US
Mailing Address - Phone:541-797-6935
Mailing Address - Fax:
Practice Address - Street 1:63455 N HIGHWAY 97 STE 13
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-5724
Practice Address - Country:US
Practice Address - Phone:541-797-6935
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