Provider Demographics
NPI:1265655377
Name:ADAMS, JAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JAN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE C
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2923
Mailing Address - Country:US
Mailing Address - Phone:251-342-5323
Mailing Address - Fax:251-344-8612
Practice Address - Street 1:801 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE C
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2923
Practice Address - Country:US
Practice Address - Phone:251-342-5323
Practice Address - Fax:251-344-8612
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice