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General NPI Number Information
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NPI Number | 1124386206
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Entity Type | Organization
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Legal Business Name | ADAMS AND ALLEN
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 300 W BROAD ST
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City | RICHMOND
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State | VA
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Zip | 23220-4219
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Country | US
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Telephone | 804-780-2888
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Fax | 804-643-1916
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Provider Business Mailing Address
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Address Line | 300 W BROAD ST
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City | RICHMOND
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State | VA
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Zip | 23220-4219
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Country | US
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Telephone | 804-780-2888
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Fax | 804-643-1916
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Authorized Official
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Title or Position | OWNER
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Name | DR. RANDY ADAMS
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Credential | DDS
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Telephone | 804-780-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401411279
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401004545
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License Number State | VA
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