Provider Demographics
NPI:1164621132
Name:ADAMO, JOHN BATTISTA (BS, DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BATTISTA
Last Name:ADAMO
Suffix:
Gender:M
Credentials:BS, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1020
Mailing Address - Street 2:31625 HIGHWAY 101
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-1020
Mailing Address - Country:US
Mailing Address - Phone:831-678-5595
Mailing Address - Fax:831-678-6273
Practice Address - Street 1:31625 HIGHWAY 101 S
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-9529
Practice Address - Country:US
Practice Address - Phone:831-678-5595
Practice Address - Fax:831-678-6273
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32924122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist