Provider Demographics
NPI:1518004449
Name:LANE V. BARKER, DMD, P.C.
Entity Type:Organization
Organization Name:LANE V. BARKER, DMD, P.C.
Other - Org Name:ATHENA DENTAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LANE
Authorized Official - Middle Name:VERLYN
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:706-546-7390
Mailing Address - Street 1:1020 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2141
Mailing Address - Country:US
Mailing Address - Phone:706-546-7390
Mailing Address - Fax:706-546-0806
Practice Address - Street 1:1020 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2141
Practice Address - Country:US
Practice Address - Phone:706-546-7390
Practice Address - Fax:706-546-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN011849261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental