Individual
DR. ADAM WAKSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1040 EAGLE LNDNG PKWY, STOCKBRIDGE, GA 30281-9072
(917) 922-2750
(678) 289-8560
Mailing address
1040 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-9072
(678) 836-2136
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
047013-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN014234
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02348781
—
NY
Enumeration date
08/01/2005
Last updated
01/28/2021
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