Organization
LANE & ASSOCIATES XVIII, DDS. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP BUTTS (VICE PRESIDENT)
(919) 809-0086
Entity
Organization
Contact information
Practice address
4303 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3605
(336) 760-8700
Mailing address
4303 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3605
(336) 760-8700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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