Provider Demographics
NPI:1437373883
Name:DORSETT, ADAM T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:T
Last Name:DORSETT
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 1:127 ROYAL TROON LN
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-6970
Mailing Address - Country:US
Mailing Address - Phone:336-998-2427
Mailing Address - Fax:336-793-8441
Practice Address - Street 1:127 ROYAL TROON LN
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006
Practice Address - Country:US
Practice Address - Phone:336-998-2427
Practice Address - Fax:336-793-8441
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC59000929Medicaid
5901813OtherGROUP MEDICAID ID