Provider Demographics
NPI:1740401850
Name:ROBERT ADKINS
Entity Type:Organization
Organization Name:ROBERT ADKINS
Other - Org Name:PRECISION DENTAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRANDENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-878-9659
Mailing Address - Street 1:1652 KAUFFMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324
Mailing Address - Country:US
Mailing Address - Phone:937-878-9659
Mailing Address - Fax:937-878-9659
Practice Address - Street 1:1652 KAUFFMAN AVE
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324
Practice Address - Country:US
Practice Address - Phone:937-878-9659
Practice Address - Fax:937-878-9659
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT ADKINS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-02
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2241505Medicaid