Provider Demographics
NPI:1215235148
Name:ADAIR, DENNIS THOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:THOMAS
Last Name:ADAIR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 82ND DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-2541
Mailing Address - Country:US
Mailing Address - Phone:503-655-9515
Mailing Address - Fax:503-655-4141
Practice Address - Street 1:15 82ND DR
Practice Address - Street 2:SUITE 240
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2541
Practice Address - Country:US
Practice Address - Phone:503-655-9515
Practice Address - Fax:503-655-4141
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR58501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice