MEDICARE: DR. ADAM L. CHORAK DDS

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	1273	WY

General Provider Information

NPI Number	:	1225290992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM L. CHORAK DDS

Provider Business Mailing Address
First Line	:	814 S DAVID ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-3736
Country	:	US
Telephone Number	:	307-265-6565
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 S DAVID ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-3736
Country	:	US
Telephone Number	:	307-265-6565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	11/15/2011

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Directions to “ DR. ADAM L. CHORAK DDS” Practice Location

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