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Organization

CENTRAL BALDWIN DENTAL CENTER, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEETH M. LANE JR. D.D.S. (VICE PRESIDENT)
(251) 947-5940
Entity
Organization

Contact information

Practice address
18100 HIGHWAY 104, ROBERTSDALE, AL 36567-8734
(251) 947-5940
(251) 947-5942
Mailing address
18100 HWY 104, ROBERTSDALE, AL 36567-8734
(251) 947-5940
(251) 947-5942

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4306
AL

Other

Enumeration date
03/31/2008
Last updated
03/31/2008
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