Provider Demographics
NPI:1699396192
Name:J MICHAEL ADAME DDS PA
Entity Type:Organization
Organization Name:J MICHAEL ADAME DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORDELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-383-4400
Mailing Address - Street 1:201 N MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2720
Mailing Address - Country:US
Mailing Address - Phone:956-464-4448
Mailing Address - Fax:956-383-6005
Practice Address - Street 1:201 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2720
Practice Address - Country:US
Practice Address - Phone:956-464-4448
Practice Address - Fax:956-464-9742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty