Provider Demographics
NPI:1396406377
Name:ADAM FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ADAM FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ADAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-266-8176
Mailing Address - Street 1:125 E. STOWELL RD.
Mailing Address - Street 2:STE. 103
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6681
Mailing Address - Country:US
Mailing Address - Phone:805-928-4391
Mailing Address - Fax:805-925-4166
Practice Address - Street 1:125 E. STOWELL RD.
Practice Address - Street 2:STE. 103
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6681
Practice Address - Country:US
Practice Address - Phone:805-928-4391
Practice Address - Fax:805-925-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty