DR. JONATHAN LANE, DMD

Dentist - Periodontics

Active Individual
NPI: 1164779294

Practice Address

38717 38TH STREET
DENTAC CREDENTIALS OFFICE
Fort Gordon, GA 30905

Phone: (706) 787-6927

Specialties

Specialty Code Primary License
Dentist 122300000X No DS039289 (PA)
Dentist - Periodontics 1223P0300X Yes DS039289 (PA)

Frequently Asked Questions

NPI 1164779294 is the National Provider Identifier for DR. JONATHAN LANE, DMD, a Dentist - Periodontics provider located in Fort Gordon, GA. This NPI was enumerated on August 8, 2012.
DR. JONATHAN LANE, DMD practices at 38717 38TH STREET, DENTAC CREDENTIALS OFFICE, Fort Gordon, GA 30905.

Quick Facts

NPI
1164779294
Type
Individual
Enumerated
Aug 8, 2012
Last Updated
Jul 26, 2016

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