Provider Demographics
NPI:1427292515
Name:AFFORDABLE DENTURES - EVANSVILLE IV, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES - EVANSVILLE IV, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-428-3384
Mailing Address - Street 1:206 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1217
Mailing Address - Country:US
Mailing Address - Phone:812-428-3384
Mailing Address - Fax:
Practice Address - Street 1:206 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1217
Practice Address - Country:US
Practice Address - Phone:812-428-3384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007421A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty