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Individual

DR. ADAM JOHN MCKISSOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1720 JET STREAM DR STE 110, COLORADO SPRINGS, CO 80921-3938
(719) 488-2188
(719) 488-2188
Mailing address
1720 JET STREAM DR STE 110, COLORADO SPRINGS, CO 80921-3938
(719) 488-2188
(719) 488-2188

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
9878
CO
1223E0200X
Endodontics
DN 16025
FL

Other

Enumeration date
05/04/2006
Last updated
05/16/2022
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