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General NPI Number Information
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NPI Number | 1699396820
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Entity Type | Individual
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Provider Name | ADAM PATRICK FORBES DMD
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Gender | Male
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 417 RIDGE RD STE A
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City | MUNSTER
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State | IN
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Zip | 46321-1571
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Country | US
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Telephone | 219-552-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 S SEMINARY AVE
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City | PARK RIDGE
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State | IL
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Zip | 60068-4361
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Country | US
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Telephone | 224-567-3072
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.032797
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12013449A
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License Number State | IN
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