Organization
LANE AND ASSOCIATES V, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY MORAN (COMPTROLLER)
(910) 814-2944
Entity
Organization
Contact information
Practice address
598 E JACKSON BLVD, SUITE 100, ERWIN, NC 28339-9629
(910) 892-8886
(910) 980-9851
Mailing address
598 E JACKSON BLVD, SUITE 100, ERWIN, NC 28339-9629
(910) 892-8886
(910) 980-9851
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1595143
UNITED CONCORDIA
NC
01
—
1872
BCBS-NC HEALTHCHOICE
NC
01
—
7901872
NC MEDICAID
NC
Enumeration date
01/17/2007
Last updated
08/22/2020
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