Healthcare Provider Details

I. General information

NPI: 1982906350
Provider Name (Legal Business Name): NATHAN J ADAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 ROBIN LN
CAMERON PARK CA
95682-8413
US

IV. Provider business mailing address

3421 ROBIN LN
CAMERON PARK CA
95682-8413
US

V. Phone/Fax

Practice location:
  • Phone: 530-677-8181
  • Fax:
Mailing address:
  • Phone: 530-677-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number59616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: