Individual
ANASTACIA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
700 RUTLEDGE AVE, CHARLESTON, SC 29403-4145
(843) 723-9582
Mailing address
1122 LANGO AVE, CHARLESTON, SC 29407-6430
(917) 696-6491
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DGD 8423
SC
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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