Healthcare Provider Details

I. General information

NPI: 1265501084
Provider Name (Legal Business Name): ADC VENTURES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 HWY 90
PACE FL
32571-1917
US

IV. Provider business mailing address

4041 HWY 90
PACE FL
32571-1917
US

V. Phone/Fax

Practice location:
  • Phone: 850-994-8185
  • Fax:
Mailing address:
  • Phone: 850-994-8185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES E FAULKNER
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 850-994-8185