Provider Demographics
NPI:1902002876
Name:ADAMS, ELIZABETH (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3242
Mailing Address - Country:US
Mailing Address - Phone:914-722-0511
Mailing Address - Fax:914-722-0512
Practice Address - Street 1:1075 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3242
Practice Address - Country:US
Practice Address - Phone:914-722-0511
Practice Address - Fax:914-722-0512
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice