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NPI Code Detail

MEDICARE: DR. LAWRENCE LYN ADAMS D.D.S.

MEDICARE: DR. LAWRENCE LYN ADAMS D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryIN12009101IN

General Provider Information

NPI Number : 1154454346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE LYN ADAMS D.D.S.
Provider Business Mailing Address
First Line : PO BOX 1430
Second Line :
City : PORTAGE
State : IN
Zip : 46368-9230
Country : US
Telephone Number : 219-763-8112
Fax Number : 219-764-3251
Provider Business Practice Location Address
First Line : 6920 INDIANAPOLIS BLVD
Second Line :
City : HAMMOND
State : IN
Zip : 46324-2206
Country : US
Telephone Number : 219-763-8112
Fax Number : 219-764-3251
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 04/20/2015

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