Provider Demographics
NPI:1972664860
Name:SOCIA, ADAM F (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:F
Last Name:SOCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3432
Mailing Address - Country:US
Mailing Address - Phone:479-636-5855
Mailing Address - Fax:479-631-6988
Practice Address - Street 1:540 NORTH 13TH STREET
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3312
Practice Address - Country:US
Practice Address - Phone:479-636-5855
Practice Address - Fax:479-631-6988
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR35271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice