Provider Demographics
NPI:1295172740
Name:LANE, BRITTANY ANNE (DDS)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:LANE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N SHORTRIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4916
Mailing Address - Country:US
Mailing Address - Phone:317-357-2235
Mailing Address - Fax:317-357-2210
Practice Address - Street 1:115 N SHORTRIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4916
Practice Address - Country:US
Practice Address - Phone:317-357-2235
Practice Address - Fax:317-357-2210
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011693A1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics