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NPI Code Detail

MEDICARE: AFFORDABLE DENTURES-EVANSVILLE V, P.C.

MEDICARE: AFFORDABLE DENTURES-EVANSVILLE V, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12011768AIN

General Provider Information

NPI Number : 1104226315
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFORDABLE DENTURES-EVANSVILLE V, P.C.
Provider Business Mailing Address
First Line : 619 N BURKHARDT RD
Second Line : SUITE A
City : EVANSVILLE
State : IN
Zip : 47715-7296
Country : US
Telephone Number : 812-475-2880
Fax Number : 812-475-3002
Provider Business Practice Location Address
First Line : 619 N BURKHARDT RD
Second Line : SUITE A
City : EVANSVILLE
State : IN
Zip : 47715-7296
Country : US
Telephone Number : 812-475-2880
Fax Number : 812-475-3002
Authorized Official
Title or Position : PRACTICE OWNER
Name : DR. MICHAEL LEE SKIRVIN
Credential : DDS
Telephone Number : 812-475-2880
Provider Enumeration Date : 08/26/2014
Last Update Date : 11/18/2015

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Directions to “AFFORDABLE DENTURES-EVANSVILLE V, P.C. ” Practice Location

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