Provider Demographics
NPI:1205115235
Name:ADAMS, RILEY SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:RILEY
Middle Name:SCOTT
Last Name:ADAMS
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 1:230 W GEORGIA AVE # 100
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-2835
Mailing Address - Country:US
Mailing Address - Phone:208-442-1088
Mailing Address - Fax:208-888-2094
Practice Address - Street 1:813 STILSON RD.; SUITE B
Practice Address - Street 2:MILLENNIUM FAMILY DENTAL- BOISE LLC
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703
Practice Address - Country:US
Practice Address - Phone:208-888-2026
Practice Address - Fax:208-888-2094
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD45961223G0001X
TX00271511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice