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Organization
LANE AND ASSOCIATES XIV DDS PA
Active
Organization
LANE AND ASSOCIATES XIV DDS PA
Active
Other names
Durham Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
1200 BROAD ST STE 300, DURHAM, NC 27705-3573
(919) 286-6646
(919) 286-6668
Mailing address
1200 BROAD ST STE 300, DURHAM, NC 27705-3573
(919) 286-6646
(919) 286-6668
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016YU
BCBS-NC HEALTHCHOICE
NC
05
—
89016TG
—
NC
Enumeration date
01/22/2007
Last updated
04/04/2023
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