Provider Demographics
NPI:1114594934
Name:ADAMS SOUTHERN DENTAL ARTS, LLC
Entity Type:Organization
Organization Name:ADAMS SOUTHERN DENTAL ARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRESTON
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-326-7444
Mailing Address - Street 1:2045 BROOKWOOD MEDICAL CTR DR STE 6
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6809
Mailing Address - Country:US
Mailing Address - Phone:205-326-7444
Mailing Address - Fax:205-637-1933
Practice Address - Street 1:2045 BROOKWOOD MEDICAL CTR DR STE 6
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-6809
Practice Address - Country:US
Practice Address - Phone:205-326-7444
Practice Address - Fax:205-637-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty