Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JONATHAN DANIEL LANE, DMD
ActiveDR. JONATHAN DANIEL LANE, DMD is a Periodontology healthcare provider located in FORT GORDON, Georgia. NPI 1164779294 is currently active in the NPPES registry. Verify at CMS.
Periodontology · FORT GORDON, GA
Registration Details
- NPI Number
- 1164779294
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 8, 2012 (13.981680833239 yrs)
- Last Updated
- Jul 26, 2016
- Licenses
-
DS039289 (PA)DS039289 (PA)
Practice Information
- Address
-
38717 38TH STREETDENTAC CREDENTIALS OFFICEFORT GORDON, GA, 309055660Browse GA providers · Browse ZIP 30905
- Phone
- 7067876927
- Fax
- 7067872082
- Primary Specialty
-
Periodontology
1223P0300X
- Additional Specialty
- Periodontology
Other Periodontology Providers in FORT GORDON, GA
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT WILLIAM HEROLD | DDS | 1609853654 |
| DR. THOMAS MICHAEL JOHNSON | DMD, MS | 1780662791 |
| DR. ADAM RANDAL LINCICUM | DMD | 1326279274 |
| DR. ANTHONY A VARGAS | D.D.S. | 1699220384 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.