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General NPI Number Information
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NPI Number | 1366695397
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Entity Type | Organization
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Legal Business Name | AMANDA WELLS LANIER, D.M.D., P.C.
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 602 BRANTLEY ST
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City | OPP
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State | AL
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Zip | 36467-1742
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Country | US
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Telephone | 334-493-3773
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Fax | 334-493-9785
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Provider Business Mailing Address
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Address Line | 602 BRANTLEY ST
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City | OPP
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State | AL
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Zip | 36467-1742
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Country | US
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Telephone | 334-493-3773
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Fax | 334-493-9785
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMANDA WELLS LANIER
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Credential | D.M.D.
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Telephone | 334-493-3773
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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 | 5236
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License Number State | AL
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