Provider Demographics
NPI:1023457025
Name:WINTERS, ADAM JAMES (DDS)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:JAMES
Last Name:WINTERS
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 1:1109 N MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1262
Mailing Address - Country:US
Mailing Address - Phone:317-517-8741
Mailing Address - Fax:765-932-4569
Practice Address - Street 1:200 CONRAD HARCOURT WAY
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1100
Practice Address - Country:US
Practice Address - Phone:765-932-5533
Practice Address - Fax:765-932-4569
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012004A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist