Provider Demographics
NPI:1689054785
Name:KIEFER, ADAM GENE (DDS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:GENE
Last Name:KIEFER
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 1:5020 W LLOYD EXPY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-6580
Mailing Address - Country:US
Mailing Address - Phone:812-228-4297
Mailing Address - Fax:
Practice Address - Street 1:5020 W LLOYD EXPY
Practice Address - Street 2:SUITE 200
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-6580
Practice Address - Country:US
Practice Address - Phone:812-228-4297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012294A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist