MEDICARE: ABIGAIL N ADAMS DMD LLC

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	261QD0000X	Dental Clinic/Center	D6264	AL

General Provider Information

NPI Number	:	1437672961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABIGAIL N ADAMS DMD LLC

Provider Business Mailing Address
First Line	:	1610 2ND AVE
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-5618
Country	:	US
Telephone Number	:	334-745-6295
Fax Number	:

Provider Business Practice Location Address
First Line	:	1610 2ND AVE
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-5618
Country	:	US
Telephone Number	:	334-745-6295
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. ABIGAIL NORTHCUTT ADAMS
Credential	:	DMD
Telephone Number	:	334-745-6295

Provider Enumeration Date	:	07/17/2017
Last Update Date	:	07/21/2022

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