Provider Demographics
NPI:1144456542
Name:MCCORMICK, ADAM PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:PATRICK
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2297 N HILL FIELD RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-6928
Mailing Address - Country:US
Mailing Address - Phone:801-779-0506
Mailing Address - Fax:801-779-4344
Practice Address - Street 1:2297 N HILL FIELD RD STE 105
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-6928
Practice Address - Country:US
Practice Address - Phone:801-779-0506
Practice Address - Fax:801-779-4344
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04420000721223S0112X
UT8018830-99241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery