Healthcare Provider Details

I. General information

NPI: 1265584064
Provider Name (Legal Business Name): LANA BATES ATCHLEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3544 HWY 431 NORTH/280 WEST
PHENIX CITY AL
36867
US

IV. Provider business mailing address

8643 CREEKRISE DR
COLUMBUS GA
31904-1400
US

V. Phone/Fax

Practice location:
  • Phone: 334-298-9900
  • Fax:
Mailing address:
  • Phone: 706-327-0168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberAL4617
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN13802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: