Individual
DR. BRENDAN MATTHEW LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(402) 294-1165
Mailing address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(402) 294-1165
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052483
NY
1223G0001X
General Practice Dentistry
052483
NY
Other
Enumeration date
09/07/2005
Last updated
07/08/2024
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