Provider Demographics
NPI:1154342657
Name:WINTER, ADAM R (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:WINTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E ROAD 140
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67871-5002
Mailing Address - Country:US
Mailing Address - Phone:620-872-8996
Mailing Address - Fax:620-872-8997
Practice Address - Street 1:130 E ROAD 140
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:KS
Practice Address - Zip Code:67871-5002
Practice Address - Country:US
Practice Address - Phone:620-872-8996
Practice Address - Fax:620-872-8997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS603991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice