Provider Demographics
NPI:1023031432
Name:MCADAMS, MAYLON TODD (DDS)
Entity type:Individual
Prefix:DR
First Name:MAYLON
Middle Name:TODD
Last Name:MCADAMS
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 1:420 ROCKY KNOB LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-2441
Mailing Address - Country:US
Mailing Address - Phone:931-433-5794
Mailing Address - Fax:931-433-0723
Practice Address - Street 1:420 ROCKY KNOB LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-2441
Practice Address - Country:US
Practice Address - Phone:931-433-5794
Practice Address - Fax:931-433-0723
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000076581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice