Organization
JASON M. LANE DDS, LLC
Active
Other names
Willow Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LANE DDS (OWNER/MANAGER)
(520) 227-6521
Entity
Organization
Contact information
Practice address
23375 W BELUGA AVE, SUITE B, WILLOW, AK 99688
(907) 631-3521
Mailing address
2000 S HYGRADE CIR, WASILLA, AK 99654-8561
(907) 631-3521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100868
AK
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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