Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 13878 | MA |
NPI | 1437183332 |
---|---|
Provider Name | Dr. William F Lane |
First Address | Plymouth, MA 02360 |
Second Address | Plymouth, MA 02360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16543 | HPHC (01) | |
590421 | UNITED CONCORDIA (01) | |
705562 | TUFTS (01) | |
T57250 | (02) | |
Z11116 | BLUE CROSS (01) | MA |