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Organization

LANE AND ASSOCIATES III, DDS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMY MORAN (COMPTROLLER)
(910) 814-2944
Entity
Organization

Contact information

Practice address
15 RAWLS ROAD, SUITE 200 BOX 160, ANGIER, NC 27501
(919) 639-2272
(919) 639-8654
Mailing address
15 RAWLS ROAD, SUITE 200 BOX 160, ANGIER, NC 27501
(919) 639-2272
(919) 639-8654

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0172C
BCBS-NC HEALTHCHOICE
NC
01
138012
UNITED CONCORDIA
NC
05
890172C
NC
Enumeration date
01/16/2007
Last updated
10/02/2008
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