Provider Demographics
NPI:1811042302
Name:ADAMS, CALLY LANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CALLY
Middle Name:LANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7 WATERFRONT PL
Mailing Address - Street 2:500 ALA MOANA BLVD SUITE 220
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4920
Mailing Address - Country:US
Mailing Address - Phone:808-523-3103
Mailing Address - Fax:808-523-3122
Practice Address - Street 1:7 WATERFRONT PL
Practice Address - Street 2:500 ALA MOANA BLVD SUITE 220
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4920
Practice Address - Country:US
Practice Address - Phone:808-523-3103
Practice Address - Fax:808-523-3122
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE6561122300000X
HIDT 22891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2840-6561Medicaid