Individual
DR. SUSAN S ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1321 VETERANS BLVD, FESTUS, MO 63028-2329
(636) 931-4020
Mailing address
1100 CONWYCK LN, SAINT LOUIS, MO 63131-2630
(314) 482-6270
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
015628
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015628
MISSOURI DENTAL BOARD
MO
Enumeration date
08/03/2015
Last updated
08/03/2015
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