MEDICARE: MS. LAURA ADAMS RDHBS

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	124Q00000X	Dental Hygienist	RDH3604	ME

General Provider Information

NPI Number	:	1992021448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA ADAMS RDHBS

Provider Business Mailing Address
First Line	:	168 FORESIDE RD APT D
Second Line	:
City	:	TOPSHAM
State	:	ME
Zip	:	04086-5161
Country	:	US
Telephone Number	:	207-729-4871
Fax Number	:

Provider Business Practice Location Address
First Line	:	168 FORESIDE RD APT D
Second Line	:
City	:	TOPSHAM
State	:	ME
Zip	:	04086-5161
Country	:	US
Telephone Number	:	207-729-4871
Fax Number	:

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

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	04/09/2010

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