Provider Demographics
NPI:1043249915
Name:ADAMS, MAXWELL C (DDS)
Entity Type:Individual
Prefix:
First Name:MAXWELL
Middle Name:C
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 1:1000 ROHRERSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-519-5297
Mailing Address - Fax:717-519-5290
Practice Address - Street 1:1000 ROHRERSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-519-5297
Practice Address - Fax:717-519-5290
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030396L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAD1382776OtherHIGHMARK BLUE SHIELD
PA001911723001Medicaid
PA20016597OtherAMERIHEALTH MERCY
PA50000508OtherCAPITAL BLUE CROSS
PA6461942001OtherCIGNA
PA01911723Medicaid
PA001911723001Medicaid
PAAD1382776OtherHIGHMARK BLUE SHIELD
PA6461942001OtherCIGNA
PA01911723Medicaid