Healthcare Provider Details

I. General information

NPI: 1912974791
Provider Name (Legal Business Name): TIMOTHY WAYNE ADAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 S COLORADO BLVD SUITE 250
DENVER CO
80246-8008
US

IV. Provider business mailing address

695 S COLORADO BLVD SUITE 250
DENVER CO
80246-8008
US

V. Phone/Fax

Practice location:
  • Phone: 303-733-7731
  • Fax: 303-733-7283
Mailing address:
  • Phone: 303-733-7731
  • Fax: 303-733-7283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number00317
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: