Provider Demographics
NPI:1942685722
Name:ADAMS, ALLYSA CLAIRE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLYSA
Middle Name:CLAIRE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 FITE WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-9394
Mailing Address - Country:US
Mailing Address - Phone:717-786-1717
Mailing Address - Fax:717-786-8508
Practice Address - Street 1:103 FITE WAY
Practice Address - Street 2:SUITE A
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-9394
Practice Address - Country:US
Practice Address - Phone:717-786-1717
Practice Address - Fax:717-786-8508
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040306122300000X
MADN1856583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist