Organization
BRIAN LANE D D S PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN LANE (PRESIDENT)
(501) 796-3903
Entity
Organization
Contact information
Practice address
17 EAGLE PARK DR, VILONIA, AR 72173-9050
(501) 425-1583
Mailing address
PO BOX 130, VILONIA, AR 72173-0130
(501) 796-3903
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
06/10/2020
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