MEDICARE: AFFORDABLE DENTURES - MYRTLE BEACH, LL, 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
1	122300000X	Dentist	3874	SC

General Provider Information

NPI Number	:	1396889697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE DENTURES - MYRTLE BEACH, LL, P.C.

Provider Business Mailing Address
First Line	:	1267 38TH AVE N
Second Line	:	SPACE 219
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1313
Country	:	US
Telephone Number	:	843-448-3810
Fax Number	:

Provider Business Practice Location Address
First Line	:	1267 38TH AVE N
Second Line	:	SPACE 219
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1313
Country	:	US
Telephone Number	:	843-448-3810
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TAMEKO ALFORD
Credential	:	DDS
Telephone Number	:	843-448-3810

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/20/2010

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1225272313 — AFFORDABLE DENTURES - MYRTLE BEACH, P.C.
Practice Location Address:

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29577-1313

Practice Phone: 843-448-3810
Practice Fax:

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