Individual
ADAM STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1003 W TOLEDO ST, FREMONT, IN 46737-2075
(260) 495-2255
Mailing address
5515 THE PROPHETS PASS, FORT WAYNE, IN 46845-9474
(260) 413-3015
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013241A
IN
1223G0001X
General Practice Dentistry
12013241A
IN
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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