Provider Demographics
NPI:1831484609
Name:BAXTER, LANE NAPIER (DMD)
Entity Type:Individual
Prefix:DR
First Name:LANE
Middle Name:NAPIER
Last Name:BAXTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 PIEDMONT ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-1345
Mailing Address - Country:US
Mailing Address - Phone:662-231-4476
Mailing Address - Fax:
Practice Address - Street 1:226 HIGHWAY 18 WEST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:MS
Practice Address - Zip Code:39153
Practice Address - Country:US
Practice Address - Phone:601-782-9919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3591-111223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health