Provider Demographics
NPI:1497130926
Name:ADAMSON, ANNE C (DDS)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:ADAMSON
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 1:4014 LAKE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7692
Mailing Address - Country:US
Mailing Address - Phone:907-235-7585
Mailing Address - Fax:
Practice Address - Street 1:4014 LAKE ST STE 210
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7692
Practice Address - Country:US
Practice Address - Phone:907-235-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021660122300000X
AK1669421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist