Individual provider · NPI-1

Dr. John E. Adcock, D.D.S., M.S.

Dentist, Periodontics · Tyler, TX

NPI number1922005503
StatusActive
Last updated in NPPESJul 9, 2007

Details

NPI
1922005503
Entity type
Individual (NPI-1)
Name
Dr. John E. Adcock
Credential
D.D.S., M.S.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 28, 2005
Last updated
Jul 9, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223P0300X Dentist, Periodontics10911TXYes

Practice location

3805 Brookside Dr
Tyler, TX 75701-9421

Phone 903-288-8805 · Fax 903-509-0160

Mailing address

3805 Brookside Dr
Tyler, TX 75701-9421

Phone 903-288-8805 · Fax 903-509-0160

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