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1972689958
RICKY LANE
STATESBORO, GA
NPI
1972689958
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: GA 10959)
Enumeration Date
2006-10-31
Last Update Date
2007-07-08
Business Address
Dr. RICKY LANE DDS, FAGD
504 GENTILLY ROAD
STATESBORO, GA 30458
Phone number: 912-764-5625
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Mailing Address
Dr. RICKY LANE DDS, FAGD
223 MAGNOLIA PL
STATESBORO, GA 30461-4250
Phone number: 912-587-2055
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