Organization
EDWARD D. LACY, DMD. FAGD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD D LACY DMD FAGD (PRESIDENT)
(503) 692-0337
Entity
Organization
Contact information
Practice address
8220 SW WARM SPRINGS ST, SUITE 200, TUALATIN, OR 97062-9097
(503) 692-0337
(503) 692-0792
Mailing address
8220 SW WARM SPRINGS ST, SUITE 200, TUALATIN, OR 97062-9097
(503) 692-0337
(503) 692-0792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4844
OR
Other
Enumeration date
01/10/2007
Last updated
08/22/2020
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