MEDICARE: DR. ASHLEIGH-MARIE LANHAM DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	29026	FL

General Provider Information

NPI Number	:	1093556730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEIGH-MARIE LANHAM DMD

Provider Business Mailing Address
First Line	:	4788 JULIANA RESERVE DR
Second Line	:
City	:	AUBURNDALE
State	:	FL
Zip	:	33823-5100
Country	:	US
Telephone Number	:	863-738-1626
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 E PALM DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-2645
Country	:	US
Telephone Number	:	863-688-1867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	06/05/2024

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