Provider Demographics
NPI:1942495031
Name:ADAMSON, NIKOLE DAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIKOLE
Middle Name:DAWN
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 RIVERSTONE PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-6414
Mailing Address - Country:US
Mailing Address - Phone:770-479-5425
Mailing Address - Fax:770-479-0291
Practice Address - Street 1:230 RIVERSTONE PKWY STE A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-6414
Practice Address - Country:US
Practice Address - Phone:770-479-5425
Practice Address - Fax:770-479-0291
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA0121601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice