Organization
LANE AND ASSOCIATES VIII DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA M DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
912 ROBESON ST, FAYETTEVILLE, NC 28305-5614
(910) 485-6316
(910) 485-6302
Mailing address
912 ROBESON ST, FAYETTEVILLE, NC 28305-5614
(910) 485-6316
(910) 485-6302
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011NG
BCBS-NC HEALTHCHOICE
NC
01
—
1309310
UNITED CONCORDIA
NC
05
—
89011NG
—
NC
Enumeration date
01/19/2007
Last updated
05/04/2022
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