Healthcare Provider Details

I. General information

NPI: 1871676270
Provider Name (Legal Business Name): SCOTT MICHAEL ADAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2458 E 146TH ST
CARMEL IN
46033-7712
US

IV. Provider business mailing address

2458 E 146TH ST
CARMEL IN
46033-7712
US

V. Phone/Fax

Practice location:
  • Phone: 317-815-6670
  • Fax: 317-815-6689
Mailing address:
  • Phone: 317-815-6670
  • Fax: 317-815-6689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12010113A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: