Brian Lane D D S PA

NPI #1831711910 in Vilonia, Arkansas

Provider Information

NPI Number: 1831711910
Entity Type: Organization
Organization Name: Brian Lane D D S PA
Primary Specialty: Dentist
Enumeration Date: May 12, 2020
Last Updated: Jun 10, 2020

Practice Location

Address: 17 EAGLE PARK DR
City: Vilonia
State: Arkansas
ZIP Code: 72173-9050
Phone: (501) 425-1583

Authorized Official

Name: DR. BRIAN LANE
Title: PRESIDENT
Phone: (501) 796-3903

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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