Provider Demographics
NPI:1912169616
Name:LANE, CARTER ALAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CARTER
Middle Name:ALAN
Last Name:LANE
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:18200 YORBA LINDA BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4056
Mailing Address - Country:US
Mailing Address - Phone:714-986-9043
Mailing Address - Fax:714-986-9052
Practice Address - Street 1:18200 YORBA LINDA BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4056
Practice Address - Country:US
Practice Address - Phone:714-986-9043
Practice Address - Fax:714-986-9052
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA472471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics