Provider Demographics
NPI:1215001334
Name:PATON, ADAM SHANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SHANE
Last Name:PATON
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 1:53076 BLACK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5957
Mailing Address - Country:US
Mailing Address - Phone:586-949-0856
Mailing Address - Fax:
Practice Address - Street 1:31290 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-1850
Practice Address - Country:US
Practice Address - Phone:586-949-0611
Practice Address - Fax:586-949-1714
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010184011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice