Individual
DR. BRIAN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 EAGLE PARK, VILONIA, AR 72173
(501) 796-3903
Mailing address
PO BOX 130, VILONIA, AR 72173
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3395
AR
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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