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Organization
LANE AND ASSOCIATES V, DDS PA
Active
Organization
LANE AND ASSOCIATES V, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY MORAN (COMPTROLLER)
(910) 814-2944
Entity
Organization
Contact information
Practice address
598 E JACKSON BLVD, SUITE 100, ERWIN, NC 28339-9629
(910) 892-8886
(910) 980-9851
Mailing address
598 E JACKSON BLVD, SUITE 100, ERWIN, NC 28339-9629
(910) 892-8886
(910) 980-9851
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1595143
UNITED CONCORDIA
NC
01
—
1872
BCBS-NC HEALTHCHOICE
NC
01
—
7901872
NC MEDICAID
NC
Enumeration date
01/17/2007
Last updated
08/22/2020
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