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Organization
ALL ABOUT TEETH
Active
Organization
ALL ABOUT TEETH
Active
Other names
Holly R. Lane, DDS, PA
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY ROSHARON LANE DDS (PRESIDENT)
(210) 545-3929
Entity
Organization
Contact information
Practice address
14400 JONES MALTSBERGER RD, SUITE 101, SAN ANTONIO, TX 78247-3748
(210) 545-3929
(210) 545-5069
Mailing address
14400 JONES MALTSBERGER RD, SUITE 101, SAN ANTONIO, TX 78247-3748
(210) 545-3929
(210) 545-5069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D 16514
TX
1223G0001X
General Practice Dentistry
D 18205
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18205
DR WYRICK'S STATE LIC. #
TX
Enumeration date
05/09/2007
Last updated
06/13/2008
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