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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