Organization
ALL ABOUT TEETH
Active
Other names
Holly R. Lane, DDS, PA
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY ROSHARON LANE DDS (PRESIDENT)
(210) 545-3929
Entity
Organization
Contact information
Practice address
14400 JONES MALTSBERGER RD, SUITE 101, SAN ANTONIO, TX 78247-3748
(210) 545-3929
(210) 545-5069
Mailing address
14400 JONES MALTSBERGER RD, SUITE 101, SAN ANTONIO, TX 78247-3748
(210) 545-3929
(210) 545-5069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D 16514
TX
1223G0001X
General Practice Dentistry
D 18205
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18205
DR WYRICK'S STATE LIC. #
TX
Enumeration date
05/09/2007
Last updated
06/13/2008
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