Individual
DR. EDWARD D LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., P.C.
Contact information
Practice address
8220 SW WARM SPRINGS ST, SUITE 200, TUALATIN, OR 97062-9338
(503) 692-0337
(503) 692-0792
Mailing address
8220 SW WARM SPRINGS ST, SUITE 200, TUALATIN, OR 97062-9338
(503) 692-0337
(503) 692-0792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4844
OR
Other
Enumeration date
09/29/2008
Last updated
09/29/2008
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