Provider Demographics
NPI:1104440874
Name:GREG L ADAMS DMD MS PSC
Entity type:Organization
Organization Name:GREG L ADAMS DMD MS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH BS
Authorized Official - Phone:270-684-2212
Mailing Address - Street 1:2880 FARRELL CRES
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1392
Mailing Address - Country:US
Mailing Address - Phone:270-684-2212
Mailing Address - Fax:
Practice Address - Street 1:2880 FARRELL CRES
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1392
Practice Address - Country:US
Practice Address - Phone:270-684-2212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty