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General NPI Number Information
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NPI Number | 1215001334
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Entity Type | Individual
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Provider Name | ADAM SHANE PATON DDS
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 31290 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-1850
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Country | US
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Telephone | 586-949-0611
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Fax | 586-949-1714
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Provider Business Mailing Address
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Address Line | 53076 BLACK CREEK DR
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City | CHESTERFIELD
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State | MI
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Zip | 48047-5957
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Country | US
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Telephone | 586-949-0856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901018401
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License Number State | MI
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