Provider Demographics
NPI:1366726531
Name:CALLY L. ADAMS, DDS, LLC
Entity type:Organization
Organization Name:CALLY L. ADAMS, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-875-4808
Mailing Address - Street 1:1325 S KIHEI RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8179
Mailing Address - Country:US
Mailing Address - Phone:808-875-4808
Mailing Address - Fax:808-875-4841
Practice Address - Street 1:1325 S KIHEI RD
Practice Address - Street 2:SUITE 108
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8179
Practice Address - Country:US
Practice Address - Phone:808-875-4808
Practice Address - Fax:808-875-4841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT22891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty