Provider Demographics
NPI:1639292840
Name:LANE B PRIOR, DDS, PA
Entity Type:Organization
Organization Name:LANE B PRIOR, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LANE
Authorized Official - Middle Name:B
Authorized Official - Last Name:PRIOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-655-8066
Mailing Address - Street 1:1515 N FLAGLER DR
Mailing Address - Street 2:STE 520
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3428
Mailing Address - Country:US
Mailing Address - Phone:561-655-8066
Mailing Address - Fax:561-655-2880
Practice Address - Street 1:1515 N FLAGLER DR
Practice Address - Street 2:STE 520
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3428
Practice Address - Country:US
Practice Address - Phone:561-655-8066
Practice Address - Fax:561-655-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN73951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty