Provider Demographics
NPI:1174984892
Name:AFFORDABLE DENTURES - TUCSON, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES - TUCSON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-624-2626
Mailing Address - Street 1:3782 S 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-6079
Mailing Address - Country:US
Mailing Address - Phone:520-624-2626
Mailing Address - Fax:
Practice Address - Street 1:3782 S 16TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6079
Practice Address - Country:US
Practice Address - Phone:520-624-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7042122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty