Organization
LANE AND ASSOCIATES XXXVI DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA DUFFY (CREDENTIALING MANAGER)
(919) 295-2757
Entity
Organization
Contact information
Practice address
900 S GARNETT ST, HENDERSON, NC 27536-4572
(252) 438-3145
(252) 430-8228
Mailing address
12450 CLEVELAND RD STE 204, GARNER, NC 27529-8355
(919) 295-2757
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
10/21/2022
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