Provider Demographics
NPI:1922836113
Name:AFFORDABLE DENTURES & IMPLANTS OF PENNSYLVANIA X, PLLC
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS OF PENNSYLVANIA X, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BOLANLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-532-2618
Mailing Address - Street 1:818 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-3513
Mailing Address - Country:US
Mailing Address - Phone:610-532-2618
Mailing Address - Fax:
Practice Address - Street 1:818 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-3513
Practice Address - Country:US
Practice Address - Phone:610-532-2618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty