Individual
DR. CHARLES EDWARD LANE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
STATE ROUTE 20 NORTH, ATHENS, WV 24712-0915
(304) 384-9805
(304) 384-8817
Mailing address
PO BOX 915, ATHENS, WV 24712-0915
(304) 384-9805
(304) 384-8817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2819
WV
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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