Individual
DR. ANDREW LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5515 W 38TH ST, INDIANAPOLIS, IN 46254-2995
(317) 880-3838
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010414A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200372230
—
IN
Enumeration date
09/06/2005
Last updated
09/23/2025
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