Organization
LANE AND ASSOCIATES XL DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
1002 JENKINS AVE, MAYSVILLE, NC 28555-4401
(910) 743-2521
(910) 743-2531
Mailing address
PO BOX 2230, ANGIER, NC 27501-2230
(919) 639-2272
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
01/19/2021
Last updated
04/28/2022
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