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General NPI Number Information
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NPI Number | 1962248708
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Entity Type | Individual
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Provider Name | ADAM PAUL MATHER DDS
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Gender | Male
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 9354 US 49, STE. L
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City | GULFPORT
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State | MS
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Zip | 39503
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Country | US
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Telephone | 228-206-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 815 PORTER ST APT 110
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City | RICHMOND
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State | VA
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Zip | 23224-2271
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Country | US
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Telephone | 757-344-6497
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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 | 111172
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License Number State | MS
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