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General NPI Number Information
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NPI Number | 1134435654
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Entity Type | Organization
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Legal Business Name | ADAMS DENTAL HEALTH, LLC
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Dates
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Enumeration Date | 08/21/2010
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Last Update Date | 08/21/2010
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Provider Practice Location Address
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Address Line | 518 MYOMA RD SUITE 200
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City | MARS
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State | PA
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Zip | 16046-2324
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Country | US
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Telephone | 724-779-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 518 MYOMA RD SUITE 200
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City | MARS
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State | PA
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Zip | 16046-2324
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Country | US
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Telephone | 724-779-7645
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. JOHN ANTHONY KOKAI
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Credential | DDS
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Telephone | 724-779-7645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS-022717-L
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License Number State | PA
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