Provider Demographics
NPI:1417100520
Name:ADAMS, RICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:ADAMS
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 1:106 W. PALISADE AVE. SUITE 202
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07637
Mailing Address - Country:US
Mailing Address - Phone:201-567-3078
Mailing Address - Fax:201-567-3098
Practice Address - Street 1:106 W. PALISADE AVE. SUITE 202
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07637
Practice Address - Country:US
Practice Address - Phone:201-567-3078
Practice Address - Fax:201-567-3098
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI17364122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist