Provider Demographics
NPI:1487704714
Name:ADAMS ORAL SURGERY INC
Entity type:Organization
Organization Name:ADAMS ORAL SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEIVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-637-5196
Mailing Address - Street 1:249 ALLEJHENY AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331
Mailing Address - Country:US
Mailing Address - Phone:717-637-5196
Mailing Address - Fax:717-637-5085
Practice Address - Street 1:249 ALLEJHENY AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331
Practice Address - Country:US
Practice Address - Phone:717-637-5196
Practice Address - Fax:717-637-5085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030876 L1223S0112X
PADS0368011223S0112X
PADS022153 L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty