# LANE AND ASSOCIATES VIII DDS PA

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

## Provider details

- **NPI number:** 1588717912
- **Authorized official:** ALICIA M DUFFY (CREDENTIALING MANAGER)
- **Authorized official phone:** (919) 295-2757

## Contact information

- **Practice address:** 912 ROBESON ST, FAYETTEVILLE, NC 28305-5614
- **Practice address phone:** (910) 485-6316
- **Practice address fax:** (910) 485-6302
- **Mailing address:** 912 ROBESON ST, FAYETTEVILLE, NC 28305-5614
- **Mailing address phone:** (910) 485-6316
- **Mailing address fax:** (910) 485-6302

## Taxonomy

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

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 05/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 011NG | BCBS-NC HEALTHCHOICE | NC |
| 01 | — | 1309310 | UNITED CONCORDIA | NC |
| 05 | — | 89011NG | — | NC |