Healthcare Provider Details

I. General information

NPI: 1508868555
Provider Name (Legal Business Name): JOANNE R ADAMSKI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 USS JAMES MADISON RD
KINGS BAY GA
31547-2531
US

IV. Provider business mailing address

85459 SAGAPONACK DR
FERNANDINA BEACH FL
32034-8785
US

V. Phone/Fax

Practice location:
  • Phone: 912-573-3327
  • Fax:
Mailing address:
  • Phone: 904-225-5375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3613
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: