MEDICARE: JENNIFER M. ADELSON, DDS, PA

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	DN15540	FL

General Provider Information

NPI Number	:	1821401001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER M. ADELSON, DDS, PA

Provider Business Mailing Address
First Line	:	501 GOLDEN ISLES DR
Second Line	:	SUITE 202
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4729
Country	:	US
Telephone Number	:	954-889-8889
Fax Number	:	954-862-6899

Provider Business Practice Location Address
First Line	:	501 GOLDEN ISLES DR
Second Line	:	SUITE 202
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4729
Country	:	US
Telephone Number	:	954-889-8889
Fax Number	:	954-862-6899

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JENNIFER M. ADELSON
Credential	:	DDS
Telephone Number	:	954-889-8889

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	06/05/2014

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