Provider Demographics
NPI:1053890046
Name:AFFORDABLE DENTURES & IMPLANTS - TUSCALOOSA, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - TUSCALOOSA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-759-5122
Mailing Address - Street 1:1516 SKYLAND BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-4232
Mailing Address - Country:US
Mailing Address - Phone:205-759-5122
Mailing Address - Fax:205-759-5124
Practice Address - Street 1:1516 SKYLAND BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-4232
Practice Address - Country:US
Practice Address - Phone:205-759-5122
Practice Address - Fax:205-759-5124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty