Healthcare Provider Details

I. General information

NPI: 1336382043
Provider Name (Legal Business Name): ADAM D HAIRR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2009
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 SAINT PETERS CHURCH RD
CHAPIN SC
29036-9361
US

IV. Provider business mailing address

112 SAINT PETERS CHURCH RD
CHAPIN SC
29036-9361
US

V. Phone/Fax

Practice location:
  • Phone: 803-816-2795
  • Fax:
Mailing address:
  • Phone: 803-816-2795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7138
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: