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Lane Avery Bland
Student in an Organized Health Care Education/Training Program in Englewood, Colorado
NPI 1811580368

Lane Avery Bland is a Student in an Organized Health Care Education/Training Program based in Englewood, CO. Lane Avery Bland practices in Englewood, CO. The NPI Number for Lane Avery Bland is 1811580368 and holds a License No. DEN.00205399 (Colorado).

The current practice location address for Lane Avery Bland is 5168 S Broadway, Englewood, CO and can be reached out via phone at 720-673-9371.

Location: 5168 S Broadway, Englewood, CO, 80113-6706
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811580368
Provider Name
Lane Avery Bland
Credential
Provider Entity Type
Individual
Gender
Male
Address
5168 S Broadway, Englewood, CO, 80113-6706
Phone Number
720-673-9371
Fax Number
Provider Enumeration Date
02/16/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5168 S Broadway
City
Englewood
State
Colorado
Zip
80113-6706
Phone Number
720-673-9371
Fax Number
person
Provider Business Mailing Address Details
Address
5168 S Broadway
City
Englewood
State
Colorado
Zip
80113-6706
Phone Number
720-673-9371
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
()
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
DEN.00205399 (Colorado)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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