# ALL ABOUT TEETH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Holly R. Lane, DDS, PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457565483
- **Authorized official:** HOLLY ROSHARON LANE DDS (PRESIDENT)
- **Authorized official phone:** (210) 545-3929

## Contact information

- **Practice address:** 14400 JONES MALTSBERGER RD, SUITE 101, SAN ANTONIO, TX 78247-3748
- **Practice address phone:** (210) 545-3929
- **Practice address fax:** (210) 545-5069
- **Mailing address:** 14400 JONES MALTSBERGER RD, SUITE 101, SAN ANTONIO, TX 78247-3748
- **Mailing address phone:** (210) 545-3929
- **Mailing address fax:** (210) 545-5069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D 16514 | TX | Yes |
| 1223G0001X | General Practice Dentistry | D 18205 | TX | — |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 06/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 18205 | DR WYRICK'S STATE LIC. \# | TX |