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Individual

ROBERT PERSON LANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4561 MILLBRANCH RD STE 1, MEMPHIS, TN 38116-7437
(901) 396-5700
(347) 442-3138
Mailing address
4561 MILLBRANCH RD STE 1, MEMPHIS, TN 38116-7437
(901) 396-5700
(347) 442-3138

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
008551
TN
1223G0001X
General Practice Dentistry
047164
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306006986
NY
Enumeration date
06/17/2008
Last updated
10/23/2018
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