Individual
DR. WILLIAM BLAKE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D., PC
Contact information
Practice address
6440 BRADLEY PARK DR, COLUMBUS, GA 31904-3082
(706) 323-7217
(706) 324-4982
Mailing address
6440 BRADLEY PARK DR, COLUMBUS, GA 31904-3082
(706) 323-7217
(706) 324-4982
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6870
GA
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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