Provider Demographics
NPI:1851931257
Name:LANE AND ASSOCIATES XXXV DDS PA
Entity Type:Organization
Organization Name:LANE AND ASSOCIATES XXXV DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-295-2757
Mailing Address - Street 1:12450 CLEVELAND ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529
Mailing Address - Country:US
Mailing Address - Phone:919-861-9017
Mailing Address - Fax:
Practice Address - Street 1:11180 E FINCH AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NC
Practice Address - Zip Code:27557-7440
Practice Address - Country:US
Practice Address - Phone:252-238-4114
Practice Address - Fax:252-966-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty