Provider Demographics
NPI:1497567085
Name:ADAMS, COURTNEY (RDH)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-7169
Mailing Address - Country:US
Mailing Address - Phone:309-764-7631
Mailing Address - Fax:309-764-7635
Practice Address - Street 1:850 36TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7169
Practice Address - Country:US
Practice Address - Phone:309-764-7631
Practice Address - Fax:309-764-7635
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL020013048124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist