Healthcare Provider Details

I. General information

NPI: 1609283522
Provider Name (Legal Business Name): AFFORDABLE DENTURES-COLUMBUS II,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 AUBURN AVE
COLUMBUS GA
31906-1708
US

IV. Provider business mailing address

2018 AUBURN AVE
COLUMBUS GA
31906-1708
US

V. Phone/Fax

Practice location:
  • Phone: 706-568-6501
  • Fax:
Mailing address:
  • Phone: 706-568-6501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN014764
License Number StateGA

VIII. Authorized Official

Name: DR. KISTY A. CAPLES
Title or Position: OWNER
Credential: DDS
Phone: 706-568-6501