Individual
DR. JOHN TIPTON LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2860 PARK ST., CALICO ROCK, AR 72519
(870) 297-3773
Mailing address
PO BOX 216, CALICO ROCK, AR 72519-0216
(870) 297-3773
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2579
AR
Other
Enumeration date
07/09/2008
Last updated
08/13/2013
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