Provider Demographics
NPI:1992431696
Name:HILARY M LANE, DDS FAMILY DENTISTRY
Entity type:Organization
Organization Name:HILARY M LANE, DDS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:MARIE-SKUZA
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-396-7490
Mailing Address - Street 1:540 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4721
Mailing Address - Country:US
Mailing Address - Phone:616-396-7490
Mailing Address - Fax:616-396-3677
Practice Address - Street 1:540 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4721
Practice Address - Country:US
Practice Address - Phone:616-396-7490
Practice Address - Fax:616-396-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental