MEDICARE: DR. GARRY RUSSELL ADAIR D.M.D.

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	DS019297L	PA

General Provider Information

NPI Number	:	1952439010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARRY RUSSELL ADAIR D.M.D.

Provider Business Mailing Address
First Line	:	1700 HORIZON DR
Second Line	:	SUITE 101
City	:	CHALFONT
State	:	PA
Zip	:	18914-3950
Country	:	US
Telephone Number	:	215-997-0740
Fax Number	:	215-997-0743

Provider Business Practice Location Address
First Line	:	1700 HORIZON DR
Second Line	:	SUITE 101
City	:	CHALFONT
State	:	PA
Zip	:	18914-3950
Country	:	US
Telephone Number	:	215-997-0740
Fax Number	:	215-997-0743

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. GARRY RUSSELL ADAIR D.M.D.” Practice Location

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