Provider Demographics
NPI:1578216594
Name:LANFORD AND MCINNIS ORTHODONTICS, LLC
Entity Type:Organization
Organization Name:LANFORD AND MCINNIS ORTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-884-4759
Mailing Address - Street 1:2315 N MAIN ST STE 120
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3880
Mailing Address - Country:US
Mailing Address - Phone:864-226-2858
Mailing Address - Fax:864-226-1147
Practice Address - Street 1:2315 N MAIN ST STE 120
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3880
Practice Address - Country:US
Practice Address - Phone:864-226-2858
Practice Address - Fax:864-226-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty