Provider Demographics
NPI:1679943898
Name:DR LANCASTER & ASSOCIATES PA
Entity Type:Organization
Organization Name:DR LANCASTER & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ELI
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:321-368-8538
Mailing Address - Street 1:1349 S INTERNATIONAL PKWY
Mailing Address - Street 2:SUITE 1441
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1697
Mailing Address - Country:US
Mailing Address - Phone:321-368-8538
Mailing Address - Fax:
Practice Address - Street 1:1349 S INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 1441
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1697
Practice Address - Country:US
Practice Address - Phone:321-368-8538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20360122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty