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Individual

DR. RICKY LANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, FAGD

Contact information

Practice address
1066 BERMUDA RUN, STATESBORO, GA 30458-0858
(912) 764-5625
Mailing address
809 SHELTER POINTE RD, STATESBORO, GA 30458-9179
(912) 587-2055

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10959
GA

Other

Enumeration date
10/31/2006
Last updated
05/06/2026
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