Provider Demographics
NPI:1780085811
Name:ADAM E STEPHENS, DDS, INC.
Entity type:Organization
Organization Name:ADAM E STEPHENS, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-876-9703
Mailing Address - Street 1:6127 CLARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4177
Mailing Address - Country:US
Mailing Address - Phone:530-876-9703
Mailing Address - Fax:530-876-8777
Practice Address - Street 1:6127 CLARK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4177
Practice Address - Country:US
Practice Address - Phone:530-876-9703
Practice Address - Fax:530-876-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA616421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty