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Organization
LANE AND ASSOCIATES IX DDS PA
Active
Organization
LANE AND ASSOCIATES IX DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MARIE DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
131 MONTGOMERY XING, BISCOE, NC 27209
(910) 428-2048
(910) 428-2328
Mailing address
131 MONTGOMERY XING, BISCOE, NC 27209
(910) 428-2048
(910) 428-2328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014KO
BCBS-NC HEALHCHOICE
NC
01
—
1595139
UNITED CONCORDIA
NC
05
—
89014K
—
NC
Enumeration date
01/19/2007
Last updated
02/21/2023
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