MEDICARE: DR. ADAM SOCARDA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16196	MI

General Provider Information

NPI Number	:	1356390256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM SOCARDA D.D.S.

Provider Business Mailing Address
First Line	:	51334 CLEAR SPRING LN
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-4023
Country	:	US
Telephone Number	:	586-991-0981
Fax Number	:

Provider Business Practice Location Address
First Line	:	2139 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4807
Country	:	US
Telephone Number	:	586-979-8466
Fax Number	:	586-979-0967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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