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General NPI Number Information
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NPI Number | 1992431696
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Entity Type | Organization
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Legal Business Name | HILARY M LANE, DDS FAMILY DENTISTRY
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 540 MICHIGAN AVE
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City | HOLLAND
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State | MI
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Zip | 49423-4721
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Country | US
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Telephone | 616-396-7490
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Fax | 616-396-3677
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Provider Business Mailing Address
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Address Line | 540 MICHIGAN AVE
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City | HOLLAND
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State | MI
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Zip | 49423-4721
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Country | US
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Telephone | 616-396-7490
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Fax | 616-396-3677
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Authorized Official
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Title or Position | DDS
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Name | HILARY MARIE-SKUZA LANE
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Credential | DDS
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Telephone | 616-396-7490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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