MEDICARE: MICHAEL ADAMS DDS

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	122300000X	Dentist	61378	KS

General Provider Information

NPI Number	:	1548798820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ADAMS DDS

Provider Business Mailing Address
First Line	:	13121 E 21ST ST N STE 107
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67230-7403
Country	:	US
Telephone Number	:	316-630-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 S MAIN ST
Second Line	:
City	:	EL DORADO
State	:	KS
Zip	:	67042-3517
Country	:	US
Telephone Number	:	316-321-4222
Fax Number	:

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

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	05/31/2017

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Directions to “ MICHAEL ADAMS DDS” Practice Location

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