Organization
LANE AND ASSOCIATES XLIII DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA MARIE DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
3445 HENDERSON DR, JACKSONVILLE, NC 28546-5233
(910) 347-1283
(252) 430-8228
Mailing address
3445 HENDERSON DR, JACKSONVILLE, NC 28546-5233
(910) 347-1283
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
01/04/2022
Last updated
04/28/2022
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