Provider Demographics
NPI:1205988342
Name:ADELSON, HARVEY JEROME (DMD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:JEROME
Last Name:ADELSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 N UNIVERSITY DRIVE TAMARAC FL 33071
Mailing Address - Street 2:SUITE 209
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321
Mailing Address - Country:US
Mailing Address - Phone:954-721-6960
Mailing Address - Fax:954-721-9067
Practice Address - Street 1:7737 N UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 207
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33071
Practice Address - Country:US
Practice Address - Phone:954-721-6960
Practice Address - Fax:954-721-9067
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist