=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568483642
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PETER J. ADAMS DDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2006
-----------------------------------------------------
Last Update Date | 03/06/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4392 HOLLAND RD SUITE 108
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23452-1151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-498-6420
-----------------------------------------------------
Fax | 757-498-0982
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4392 HOLLAND RD SUITE 108
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23452-1151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-498-6420
-----------------------------------------------------
Fax | 757-498-0982
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. CIELO TORRES
-----------------------------------------------------
Credential | CDA
-----------------------------------------------------
Telephone | 757-498-6420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 0401007050
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------