Healthcare Provider Details

I. General information

NPI: 1457112948
Provider Name (Legal Business Name): CHRISTOPHER MAGUIRE-ADAMS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27331 172ND AVENUE SE SUITE 114
COVINGTON WA
98042
US

IV. Provider business mailing address

4170 TRUXEL ROAD SUITE C
SACRAMENTO CA
95834
US

V. Phone/Fax

Practice location:
  • Phone: 844-673-9131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: JAGDEV SINGH HEIR
Title or Position: CEO/PRESIDENT
Credential:
Phone: 518-441-5483