Healthcare Provider Details

I. General information

NPI: 1497774814
Provider Name (Legal Business Name): STEPHEN JOSEPH ADAMSON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3491 ANDERSON HILL ROAD
SILVERDALE WA
98383
US

IV. Provider business mailing address

3491 ANDERSON HILL ROAD
SILVERDALE WA
98383
US

V. Phone/Fax

Practice location:
  • Phone: 360-692-8600
  • Fax: 360-692-5364
Mailing address:
  • Phone: 360-692-8600
  • Fax: 360-692-5364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8594
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number4633
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: