# BRANDON M. LACKOVICH DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417741570
- **Authorized official:** BRANDON MICHAEL LACKOVICH DDS (DENTIST)
- **Authorized official phone:** (724) 480-7363

## Contact information

- **Practice address:** 3544 BRODHEAD RD, MONACA, PA 15061-3126
- **Practice address phone:** (724) 728-1212
- **Mailing address:** 122 MOFFETT RUN RD, ALIQUIPPA, PA 15001-9499
- **Mailing address phone:** (724) 480-7363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2025
- **Last updated:** 04/05/2025