Provider Demographics
NPI:1164012092
Name:ANNE C ADAMSON DDS LLC
Entity Type:Organization
Organization Name:ANNE C ADAMSON DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-235-7585
Mailing Address - Street 1:4014 LAKE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7692
Mailing Address - Country:US
Mailing Address - Phone:907-235-7585
Mailing Address - Fax:
Practice Address - Street 1:4014 LAKE ST STE 210
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7692
Practice Address - Country:US
Practice Address - Phone:907-235-7585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty