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General NPI Number Information
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NPI Number | 1811579055
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Entity Type | Organization
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Legal Business Name | NICHOLAS V. ADAMS DMD PC
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 400 S WEST ST
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City | BAINBRIDGE
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State | GA
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Zip | 39819-3914
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Country | US
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Telephone | 229-246-2366
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 470
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City | BLAKELY
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State | GA
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Zip | 39823-0470
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Country | US
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Telephone | 229-724-7300
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. NICHOLAS V. ADAMS
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Credential | DMD
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Telephone | 229-724-7300
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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 |
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License Number State |
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