Provider Demographics
NPI:1265543177
Name:ADAMS, DAVID C (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:736 STAFFORD PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-4241
Mailing Address - Country:US
Mailing Address - Phone:619-291-5266
Mailing Address - Fax:619-291-0124
Practice Address - Street 1:420 SPRUCE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5800
Practice Address - Country:US
Practice Address - Phone:619-291-5266
Practice Address - Fax:619-291-0124
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA365111223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics