Provider Demographics
NPI:1811900103
Name:LALONDE, ADAM MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MICHAEL
Last Name:LALONDE
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:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-0189
Mailing Address - Country:US
Mailing Address - Phone:956-233-4400
Mailing Address - Fax:956-233-5626
Practice Address - Street 1:810 W OCEAN BLVD
Practice Address - Street 2:SUITE C1
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566
Practice Address - Country:US
Practice Address - Phone:956-233-4400
Practice Address - Fax:956-233-5626
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist