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General NPI Number Information
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NPI Number | 1083144992
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Entity Type | Organization
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Legal Business Name | LANE AND ASSOCIATES XXXII DDS PA
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 411 FAIRVIEW ST
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City | CLINTON
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State | NC
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Zip | 28328-2311
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Country | US
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Telephone | 910-592-3516
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Fax | 910-592-0530
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Provider Business Mailing Address
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Address Line | 120 NE MAYNARD RD
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City | CARY
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State | NC
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Zip | 27513-9615
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Country | US
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Telephone | 919-677-1932
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Fax | 919-677-2942
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | ALICIA DUFFY
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Credential |
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Telephone | 919-295-2757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 4785
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4785
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 4785
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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