=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447465000
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOUGLAS A MCADAMS DDS PZ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4200 N INTERSTATE 35 EAST
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76207-3441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-591-9362
-----------------------------------------------------
Fax | 940-484-0405
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4200 N INTERSTATE 35
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76207-3441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-591-9362
-----------------------------------------------------
Fax | 940-484-0405
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE PROPRIETOR
-----------------------------------------------------
Name | DR. DOUGLAS ARMSTRONG MCADAMS
-----------------------------------------------------
Credential | D.D.S
-----------------------------------------------------
Telephone | 940-591-9362
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 14664
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------