Provider Demographics
NPI:1073718706
Name:ADAMS, LALE O (DDS)
Entity Type:Individual
Prefix:DR
First Name:LALE
Middle Name:O
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 COLONIAL RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4019
Mailing Address - Country:US
Mailing Address - Phone:901-680-6881
Mailing Address - Fax:901-680-6882
Practice Address - Street 1:670 COLONIAL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-5160
Practice Address - Country:US
Practice Address - Phone:901-680-6881
Practice Address - Fax:901-680-6882
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice