Provider Demographics
NPI:1780886556
Name:SERLO, ADAM DAVID (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DAVID
Last Name:SERLO
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:501 EASTOWNE DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-929-2196
Mailing Address - Fax:919-490-8518
Practice Address - Street 1:501 EASTOWNE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6224
Practice Address - Country:US
Practice Address - Phone:919-929-2196
Practice Address - Fax:919-490-8518
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-01894204E00000X
NC78061223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery