Provider Demographics
NPI:1902265440
Name:BAHR, ADAM (DDS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BAHR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 E 38TH CT APT 2
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4325
Mailing Address - Country:US
Mailing Address - Phone:801-592-5021
Mailing Address - Fax:
Practice Address - Street 1:9902 MCPHERSON RD STE 25
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045
Practice Address - Country:US
Practice Address - Phone:956-725-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX339841223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry