Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 9260 | CO |
NPI | 1063804730 |
---|---|
Provider Name | Dr. Mark William Adams |
First Address | Greenwood Village, CO 80111-2803 |
Second Address | Greenwood Village, CO 80111-2803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2015 |
Last Update Date | 04/03/2015 |