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NPI Code Detail

MEDICARE: DR. DEBRA GANDY ADAMS DMD

MEDICARE: DR. DEBRA GANDY ADAMS DMD
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
1122300000XDentist8487SC

General Provider Information

NPI Number : 1619359627
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA GANDY ADAMS DMD
Provider Business Mailing Address
First Line : 2053 ARUNDEL PL
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-6201
Country : US
Telephone Number : 843-225-3353
Fax Number :
Provider Business Practice Location Address
First Line : 2053 ARUNDEL PL
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-6201
Country : US
Telephone Number : 843-225-3353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2015
Last Update Date : 06/25/2015

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