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NPI Code Detail

MEDICARE: AFFORDABLE DENTURES & IMPLANTS - TITUSVILLE, P.A.

MEDICARE: AFFORDABLE DENTURES & IMPLANTS - TITUSVILLE, P.A.
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
1122300000XDentist

General Provider Information

NPI Number : 1275139297
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFORDABLE DENTURES & IMPLANTS - TITUSVILLE, P.A.
Provider Business Mailing Address
First Line : 686 CHENEY HWY
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-6959
Country : US
Telephone Number : 321-294-6494
Fax Number :
Provider Business Practice Location Address
First Line : 686 CHENEY HWY
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-6959
Country : US
Telephone Number : 321-294-6494
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LOUIS TRACI
Credential : DDS
Telephone Number : 321-294-6494
Provider Enumeration Date : 12/06/2020
Last Update Date : 12/06/2020

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Directions to “AFFORDABLE DENTURES & IMPLANTS - TITUSVILLE, P.A. ” Practice Location

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