| NPI | 1437566577 |
|---|---|
| Doing Business As | LANE AVENUE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ANTHONY ROBERT PETRONE Owner 904-783-1422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN19821) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |