| Dr Jonathan Daniel Lane, DMD | |
|
38717 38th Street, Dentac Credentials Office, Fort Gordon, GA 30905-5660 | |
| (706) 787-6927 | |
| (706) 787-2082 |
| Full Name | Dr Jonathan Daniel Lane |
|---|---|
| Gender | Male |
| Speciality | Dentist - Periodontics |
| Location | 38717 38th Street, Fort Gordon, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164779294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS039289 (Pennsylvania) | Secondary |
| 1223P0300X | Dentist - Periodontics | DS039289 (Pennsylvania) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jonathan Daniel Lane, DMD Hq, 618th Dental Company (as), Unit #15652, Bldg S-5403, Apo, AP 96205-5652 Ph: (011) 822-2600 | Dr Jonathan Daniel Lane, DMD 38717 38th Street, Dentac Credentials Office, Fort Gordon, GA 30905-5660 Ph: (706) 787-6927 |
Dr. Ryan Dale Swiss, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 320 W Hospital Rd, Fort Gordon, GA 30905 Phone: 706-787-8105 | |
Dr. Carsen Robert Mcdaniel, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 33801 Academic Drive, Fort Gordon, GA 30905 Phone: 706-787-6927 | |
Dr. Jason Scott Bullock, D.M.D Dentist Medicare: Not Enrolled in Medicare Practice Location: Bldg 38717 38th Street, Usa Dental Activity, Fort Gordon, GA 30905 Phone: 706-787-6927 Fax: 706-787-2082 | |
Kyung Sang Kim, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: Tingay Dental Clinic, 320 W Hospital Road, Fort Gordon, GA 30905 Phone: 067-875-1027 | |
Dr. Justin Phillip Galliani, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 38801 Academic Drive, Suite B & C, Fort Gordon, GA 30905 Phone: 707-694-6032 | |
Dr. Jennifer Victoria Sabol, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: Tingay Dental Clinic, 320 West Hospital Road, Fort Gordon, GA 30905 Phone: 706-787-4106 |