Provider Demographics
NPI:1710056528
Name:ADAMS, THOMAS J (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:ADAMS
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 1:330 W FRONTAGE RD
Mailing Address - Street 2:SUITE 2W
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3467
Mailing Address - Country:US
Mailing Address - Phone:847-784-5555
Mailing Address - Fax:847-784-5557
Practice Address - Street 1:330 W FRONTAGE RD
Practice Address - Street 2:SUITE 2W
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3467
Practice Address - Country:US
Practice Address - Phone:847-784-5555
Practice Address - Fax:847-784-5557
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist