Provider Demographics
NPI:1689245896
Name:CHRISTOPHER B. LANE, DDS, PA
Entity Type:Organization
Organization Name:CHRISTOPHER B. LANE, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-636-3366
Mailing Address - Street 1:2306 M L KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-4449
Mailing Address - Country:US
Mailing Address - Phone:252-636-3366
Mailing Address - Fax:
Practice Address - Street 1:2306 M L KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-4449
Practice Address - Country:US
Practice Address - Phone:252-636-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental