Individual
DR. MATTHEW LANE FAIRBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
865 SOUTH PEAR ORCHARD ROAD, RIDGELAND, MS 39157
(601) 956-4007
(601) 956-2901
Mailing address
865 SOUTH PEAR ORCHARD ROAD, RIDGELAND, MS 39157
(601) 956-4007
(601) 956-2901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3292-04
MS
Other
Enumeration date
10/12/2006
Last updated
07/18/2007
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