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Organization

LANE ORAL & MAXILLOFACIAL SURGERY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM F LANE DMD (PRESIDENT)
(508) 746-8700
Entity
Organization

Contact information

Practice address
30 RESNIK RD, PLYMOUTH, MA 02360
(508) 746-8700
(508) 746-2434
Mailing address
30 RESNIK RD, PLYMOUTH, MA 02360
(508) 746-8700
(508) 746-2434

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
13878
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
21191
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
X11116
BLUE CROSS GROUP
MA
Enumeration date
09/20/2006
Last updated
10/06/2011
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