Provider Demographics
NPI:1639371701
Name:ADAMS, LINDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
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 1:11382 MOUNTAIN VIEW AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3878
Mailing Address - Country:US
Mailing Address - Phone:909-796-7303
Mailing Address - Fax:909-796-2784
Practice Address - Street 1:11382 MOUNTAIN VIEW AVE STE B
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3878
Practice Address - Country:US
Practice Address - Phone:909-796-7303
Practice Address - Fax:909-796-2784
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26325122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist