Healthcare Provider Details

I. General information

NPI: 1225111891
Provider Name (Legal Business Name): ADAMS ORAL SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SOUTH WASHINGTON ST #21
GETTYSBURG PA
17325
US

IV. Provider business mailing address

455 SOUTH WASHINGTON ST #21
GETTYSBURG PA
17325
US

V. Phone/Fax

Practice location:
  • Phone: 717-337-3232
  • Fax: 717-337-1032
Mailing address:
  • Phone: 717-337-3232
  • Fax: 717-337-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS030876L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS036801
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS022153L
License Number StatePA

VIII. Authorized Official

Name: MRS. JEANETTE SCHEIVERT
Title or Position: OFFICE MANAGER
Credential:
Phone: 717-637-5196