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General NPI Number Information
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NPI Number | 1518038306
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Entity Type | Individual
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Provider Name | EDWARD ELI LANCASTER III D.M.D
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1349 S INTERNATIONAL PKWY STE 1441
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City | LAKE MARY
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State | FL
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Zip | 32746-1698
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Country | US
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Telephone | 407-833-9533
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Fax |
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Provider Business Mailing Address
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Address Line | 130 CASCADE TER
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-6228
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Country | US
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Telephone | 321-977-0820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3271
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN20360
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License Number State | FL
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