MEDICARE: DR. ADAM JOSEPH VERRETT

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	23550	TX

General Provider Information

NPI Number	:	1871787291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM JOSEPH VERRETT

Provider Business Mailing Address
First Line	:	27402 CAMINO HVN
Second Line	:
City	:	BOERNE
State	:	TX
Zip	:	78015-4879
Country	:	US
Telephone Number	:	210-860-0951
Fax Number	:

Provider Business Practice Location Address
First Line	:	4499 MEDICAL DR STE 190
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3768
Country	:	US
Telephone Number	:	210-614-3915
Fax Number	:	210-614-5234

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

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	05/03/2016

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Directions to “ DR. ADAM JOSEPH VERRETT ” Practice Location

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