Provider Demographics
NPI:1033989017
Name:CHARLES J LALANE DMD LLC
Entity Type:Organization
Organization Name:CHARLES J LALANE DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LALANE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-732-3079
Mailing Address - Street 1:2521 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7721
Mailing Address - Country:US
Mailing Address - Phone:561-732-3079
Mailing Address - Fax:561-733-9036
Practice Address - Street 1:2521 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7721
Practice Address - Country:US
Practice Address - Phone:561-732-3079
Practice Address - Fax:561-733-9036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty