# LANE AND ASSOCIATES I DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154336642
- **Authorized official:** ALICIA DUFFY (CREDENTIALING MANAGER)
- **Authorized official phone:** (919) 292-2757

## Contact information

- **Practice address:** 1213 N MAIN ST, FUQUAY VARINA, NC 27526-2616
- **Practice address phone:** (919) 552-9711
- **Practice address fax:** (919) 552-2157
- **Mailing address:** 1213 N MAIN ST, FUQUAY VARINA, NC 27526-2616
- **Mailing address phone:** (919) 552-9711
- **Mailing address fax:** (919) 552-2157

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4785 | NC | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 12/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 890147A | — | NC |