Provider Demographics
NPI:1811377922
Name:ADELSON INSTITUTE
Entity Type:Organization
Organization Name:ADELSON INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-721-6960
Mailing Address - Street 1:7737 N UNIVERSITY DR
Mailing Address - Street 2:STE 7
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2961
Mailing Address - Country:US
Mailing Address - Phone:954-721-6960
Mailing Address - Fax:
Practice Address - Street 1:7737 N UNIVERSITY DR
Practice Address - Street 2:STE 7
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2961
Practice Address - Country:US
Practice Address - Phone:954-721-6960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBA84543261223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty