MEDICARE: DR. CHRIS LEE ADKINS 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	10292	GA

General Provider Information

NPI Number	:	1689677593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRIS LEE ADKINS D.D.S.

Provider Business Mailing Address
First Line	:	236 STOCKBRIDGE RD
Second Line	:	STE A
City	:	JONESBORO
State	:	GA
Zip	:	30236-3629
Country	:	US
Telephone Number	:	770-471-6522
Fax Number	:	770-471-6567

Provider Business Practice Location Address
First Line	:	236 STOCKBRIDGE RD
Second Line	:	STE A
City	:	JONESBORO
State	:	GA
Zip	:	30236-3629
Country	:	US
Telephone Number	:	770-471-6522
Fax Number	:	770-471-6567

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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