Provider Demographics
NPI:1780762971
Name:ADKINS, KERMIT (DDS)
Entity type:Individual
Prefix:
First Name:KERMIT
Middle Name:
Last Name:ADKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 E OLIVE ROAD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6153
Mailing Address - Country:US
Mailing Address - Phone:850-476-4880
Mailing Address - Fax:850-476-0722
Practice Address - Street 1:2227 E OLIVE ROAD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6153
Practice Address - Country:US
Practice Address - Phone:850-476-4880
Practice Address - Fax:850-476-0722
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist