MEDICARE: DR. LANCE MYERS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401418299	VA

General Provider Information

NPI Number	:	1700661402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANCE MYERS DDS

Provider Business Mailing Address
First Line	:	10001 PARK ROYAL DR
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-1847
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1890 PRESTON WHITE DR STE 200
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-5430
Country	:	US
Telephone Number	:	703-437-8811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	08/30/2023

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