Provider Demographics
NPI:1619090040
Name:NALER, ADAM LUCAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LUCAS
Last Name:NALER
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 1:10631 E 46TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-3782
Mailing Address - Country:US
Mailing Address - Phone:816-726-1910
Mailing Address - Fax:816-350-1975
Practice Address - Street 1:4701 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64136-1161
Practice Address - Country:US
Practice Address - Phone:816-350-1007
Practice Address - Fax:816-350-1975
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040132551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice