Provider Demographics
NPI:1275643371
Name:ADAMS, BROOKE N (DDS)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:N
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 W MICHIGAN STREET
Mailing Address - Street 2:DS307
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5186
Mailing Address - Country:US
Mailing Address - Phone:317-278-3632
Mailing Address - Fax:317-274-2603
Practice Address - Street 1:1121 W MICHIGAN STREET
Practice Address - Street 2:DS307B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5186
Practice Address - Country:US
Practice Address - Phone:615-373-8001
Practice Address - Fax:615-371-9589
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8370122300000X
IN12011104A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist