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General NPI Number Information
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NPI Number | 1730547217
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Entity Type | Organization
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Legal Business Name | AFFORDABLE DENTURES - BLUFF CITY, P.C.
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 4516 HIGHWAY 11 E
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City | BLUFF CITY
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State | TN
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Zip | 37618-2553
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Country | US
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Telephone | 423-538-5197
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Fax |
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Provider Business Mailing Address
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Address Line | 4516 HIGHWAY 11 E
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City | BLUFF CITY
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State | TN
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Zip | 37618-2553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DMD/PRACTICE OWNER
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Name | TERRY L BROWN
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Credential |
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Telephone | 423-538-5197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS0000009827
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License Number State | TN
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