Provider Demographics
NPI:1326783721
Name:BRITTANY A LANE DDS MSD LLC
Entity Type:Organization
Organization Name:BRITTANY A LANE DDS MSD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:317-357-2235
Mailing Address - Street 1:115 N SHORTRIDGE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4917
Mailing Address - Country:US
Mailing Address - Phone:317-357-2235
Mailing Address - Fax:317-357-2210
Practice Address - Street 1:115 N SHORTRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4917
Practice Address - Country:US
Practice Address - Phone:317-357-2235
Practice Address - Fax:317-357-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty