Healthcare Provider Details

I. General information

NPI: 1730324435
Provider Name (Legal Business Name): JOSEPH L ADKINS LD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 WEBSTER ST
LEWISTON ME
04240-1600
US

IV. Provider business mailing address

801 WEBSTER ST
LEWISTON ME
04240-1600
US

V. Phone/Fax

Practice location:
  • Phone: 207-514-0660
  • Fax: 207-514-0660
Mailing address:
  • Phone: 207-514-0660
  • Fax: 207-514-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number5058
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: