Provider Demographics
NPI:1457394140
Name:MCADAMS, MARK ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLAN
Last Name:MCADAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:108 S RANCH HOUSE RD
Mailing Address - Street 2:STE 1200
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-2663
Mailing Address - Country:US
Mailing Address - Phone:817-441-8003
Mailing Address - Fax:817-441-8223
Practice Address - Street 1:108 S RANCH HOUSE RD
Practice Address - Street 2:STE 1200
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-2691
Practice Address - Country:US
Practice Address - Phone:817-441-8003
Practice Address - Fax:817-441-8223
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX163681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU00922Medicare UPIN