Provider Demographics
NPI:1730547217
Name:AFFORDABLE DENTURES - BLUFF CITY, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES - BLUFF CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-538-5197
Mailing Address - Street 1:4516 HIGHWAY 11 E
Mailing Address - Street 2:
Mailing Address - City:BLUFF CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37618-2553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4516 HIGHWAY 11 E
Practice Address - Street 2:
Practice Address - City:BLUFF CITY
Practice Address - State:TN
Practice Address - Zip Code:37618-2553
Practice Address - Country:US
Practice Address - Phone:423-538-5197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000009827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty