Organization
LANE AND ASSOCIATES IX DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MARIE DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
131 MONTGOMERY XING, BISCOE, NC 27209
(910) 428-2048
(910) 428-2328
Mailing address
131 MONTGOMERY XING, BISCOE, NC 27209
(910) 428-2048
(910) 428-2328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014KO
BCBS-NC HEALHCHOICE
NC
01
—
1595139
UNITED CONCORDIA
NC
05
—
89014K
—
NC
Enumeration date
01/19/2007
Last updated
02/21/2023
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