Provider Demographics
NPI:1720074834
Name:ADAMS, THOMAS W (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:ADAMS
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 1:116 W SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:MUNISING
Mailing Address - State:MI
Mailing Address - Zip Code:49862-1124
Mailing Address - Country:US
Mailing Address - Phone:906-387-4200
Mailing Address - Fax:906-387-4201
Practice Address - Street 1:116 W SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:MUNISING
Practice Address - State:MI
Practice Address - Zip Code:49862-1124
Practice Address - Country:US
Practice Address - Phone:906-387-4200
Practice Address - Fax:906-387-4201
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010120961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice