Provider Demographics
NPI:1427299064
Name:AFFORDABLE DENTAL SOLUTIONS,LLC
Entity type:Organization
Organization Name:AFFORDABLE DENTAL SOLUTIONS,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDEEP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BHULLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-279-2020
Mailing Address - Street 1:3993 LAWRENCEVILLE HWY NW
Mailing Address - Street 2:SUITE#100
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2897
Mailing Address - Country:US
Mailing Address - Phone:770-279-2020
Mailing Address - Fax:
Practice Address - Street 1:3993 LAWRENCEVILLE HWY NW
Practice Address - Street 2:SUITE#100
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2897
Practice Address - Country:US
Practice Address - Phone:770-279-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA549522689NMedicaid