Provider Demographics
NPI:1699790329
Name:MCEWAN, LANE (DMD)
Entity type:Individual
Prefix:DR
First Name:LANE
Middle Name:
Last Name:MCEWAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1952
Mailing Address - Country:US
Mailing Address - Phone:845-561-3689
Mailing Address - Fax:845-561-3689
Practice Address - Street 1:5109 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1952
Practice Address - Country:US
Practice Address - Phone:845-561-3689
Practice Address - Fax:845-561-3689
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY422591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice