Jason M. Lane Dds, LLC

NPI #1912381658 in Willow, Alaska

Provider Information

NPI Number: 1912381658
Entity Type: Organization
Organization Name: Jason M. Lane Dds, LLC
Primary Specialty: Dentist
Enumeration Date: Jul 13, 2015
Last Updated: Jul 13, 2015

Practice Location

Address: 23375 W BELUGA AVE
Address 2: SUITE B
City: Willow
State: Alaska
ZIP Code: 99688
Phone: (907) 631-3521

Authorized Official

Name: JASON LANE, DDS
Title: OWNER/MANAGER
Phone: (520) 227-6521

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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