Lane And Associates Xxxix DDS PA
Dentist in Mount Airy, NC. Organization (NPI-2).
NPI number1538776455
StatusActive
Last updated in NPPESOct 6, 2022
Details
- NPI
- 1538776455
- Entity type
- Organization (NPI-2)
- Legal business name
- Lane And Associates Xxxix DDS PA
- Organization subpart
- No
- Enumeration date
- Sep 24, 2020
- Certification date
- Oct 6, 2022
- Last updated
- Oct 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
| 1223G0001X | Dentist, General Practice | – | – |
Practice location
161 Kodiak LnMount Airy, NC 27030-5399
Phone 336-789-1025 · Fax 336-789-1158
Mailing address
161 Kodiak LnMount Airy, NC 27030-5399
Phone 336-789-1025 · Fax 336-789-1158
Authorized official
Alicia Duffy
Credentialing Manager
9192952757
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