Provider Demographics
NPI:1275618969
Name:STEVENS, JAMES ADAMS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ADAMS
Last Name:STEVENS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2805 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:770-476-2252
Mailing Address - Fax:770-476-3798
Practice Address - Street 1:2805 PEACHTREE IND BLVD
Practice Address - Street 2:STE 113
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097
Practice Address - Country:US
Practice Address - Phone:770-476-2252
Practice Address - Fax:770-476-3798
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0096991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice