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NPI Code Detail

MEDICARE: AFFORDABLE DENTURES - MANSFIELD, BRANDON WASHINGTON, DDS, INC.

MEDICARE: AFFORDABLE DENTURES - MANSFIELD, BRANDON WASHINGTON, DDS, INC.
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
1122300000XDentist30.023500OH

General Provider Information

NPI Number : 1588022362
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFORDABLE DENTURES - MANSFIELD, BRANDON WASHINGTON, DDS, INC.
Provider Business Mailing Address
First Line : 2010 AUGUST DR STE 106
Second Line :
City : ONTARIO
State : OH
Zip : 44906-3350
Country : US
Telephone Number : 419-529-0142
Fax Number :
Provider Business Practice Location Address
First Line : 2010 AUGUST DR STE 106
Second Line :
City : ONTARIO
State : OH
Zip : 44906-3350
Country : US
Telephone Number : 419-529-0142
Fax Number :
Authorized Official
Title or Position : DDS/PRACTICE OWNER
Name : BRANDON WASHINGTON
Credential :
Telephone Number : 419-529-0142
Provider Enumeration Date : 02/08/2016
Last Update Date : 02/08/2016

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Directions to “AFFORDABLE DENTURES - MANSFIELD, BRANDON WASHINGTON, DDS, INC. ” Practice Location

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