Organization
LANE & ASSOCIATES XV DDS PA
Active
Other names
Sanford Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
2617 S HORNER BLVD, SANFORD, NC 27332-8032
(919) 774-1993
(919) 774-0580
Mailing address
2617 S HORNER BLVD, SANFORD, NC 27332-8032
(919) 774-1993
(919) 774-0580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016YG
BCBS-NC HEALTHCHOICE
NC
05
—
89016TF
—
NC
Enumeration date
01/22/2007
Last updated
06/13/2022
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