Provider Demographics
NPI:1154570737
Name:ADAMIC, DAVID DUANE (DDS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DUANE
Last Name:ADAMIC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:DUANE
Other - Last Name:ADAMIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:810 ST JOHN PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4414
Mailing Address - Country:US
Mailing Address - Phone:951-652-6767
Mailing Address - Fax:951-652-9612
Practice Address - Street 1:810 ST JOHN PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4414
Practice Address - Country:US
Practice Address - Phone:951-652-6767
Practice Address - Fax:951-652-9612
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics