# LANE AND ASSOCIATES V, DDS PA

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

## Provider details

- **NPI number:** 1275685844
- **Authorized official:** MRS. TAMMY MORAN (COMPTROLLER)
- **Authorized official phone:** (910) 814-2944

## Contact information

- **Practice address:** 598 E JACKSON BLVD, SUITE 100, ERWIN, NC 28339-9629
- **Practice address phone:** (910) 892-8886
- **Practice address fax:** (910) 980-9851
- **Mailing address:** 598 E JACKSON BLVD, SUITE 100, ERWIN, NC 28339-9629
- **Mailing address phone:** (910) 892-8886
- **Mailing address fax:** (910) 980-9851

## Taxonomy

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

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1595143 | UNITED CONCORDIA | NC |
| 01 | — | 1872 | BCBS-NC HEALTHCHOICE | NC |
| 01 | — | 7901872 | NC MEDICAID | NC |