Provider Demographics
NPI:1922830835
Name:AFFORDABLE DENTURES & IMPLANTS - KENTUCKY II, PLLC
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - KENTUCKY II, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLAJUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEDOYIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:270-215-4086
Mailing Address - Street 1:2594 CALUMET TRCE STE 1&2A
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4673
Mailing Address - Country:US
Mailing Address - Phone:270-215-4086
Mailing Address - Fax:
Practice Address - Street 1:2594 CALUMET TRCE STE 1&2A
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4673
Practice Address - Country:US
Practice Address - Phone:270-215-4086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty