Provider Demographics
NPI:1316584568
Name:LANE SLEEP SOLUTIONS PA
Entity Type:Organization
Organization Name:LANE SLEEP SOLUTIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-395-3503
Mailing Address - Street 1:1590 NW 10TH AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1339
Mailing Address - Country:US
Mailing Address - Phone:561-395-3503
Mailing Address - Fax:
Practice Address - Street 1:1590 NW 10TH AVE STE 402
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1339
Practice Address - Country:US
Practice Address - Phone:561-395-3503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty