Individual
MRS. LACEY LEE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3189 MAPLE DR NE, ATLANTA, GA 30305-2501
(770) 998-3838
Mailing address
713 WOODBRIDGE DR, WOODSTOCK, GA 30188-7146
(509) 301-2081
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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