Provider Demographics
NPI:1699396820
Name:FORBES, ADAM PATRICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:PATRICK
Last Name:FORBES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 S SEMINARY AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4361
Mailing Address - Country:US
Mailing Address - Phone:224-567-3072
Mailing Address - Fax:
Practice Address - Street 1:417 RIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1571
Practice Address - Country:US
Practice Address - Phone:219-552-7674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032797122300000X
IN12013449A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist