Healthcare Provider Details

I. General information

NPI: 1538577028
Provider Name (Legal Business Name): KEVIN ADAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 12/05/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39TH MEDICAL GROUP U.S. AIR FORCE INCIRLIK AIR BASE B O X 185
APO AE
09824
US

IV. Provider business mailing address

39TH MEDICAL GROUP U.S. AIR FORCE INCIRLIK AIR BASE. B O X 185
APO AP
09824-5185
US

V. Phone/Fax

Practice location:
  • Phone: 314-676-6368
  • Fax:
Mailing address:
  • Phone: 314-676-6368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDT-2511
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: