Provider Demographics
NPI:1952408155
Name:LANHAM, JAMES CLAYTON (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CLAYTON
Last Name:LANHAM
Suffix:
Gender:M
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 EAST PALM DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2645
Mailing Address - Country:US
Mailing Address - Phone:863-688-1867
Mailing Address - Fax:
Practice Address - Street 1:115 EAST PALM DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2645
Practice Address - Country:US
Practice Address - Phone:863-688-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11835122300000X
WV2920122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist