Individual
PETER G. LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
907 ROUTE 32, UNCASVILLE, CT 06382-1917
(860) 848-2215
(860) 848-8844
Mailing address
PO BOX 465, UNCASVILLE, CT 06382-0465
(860) 848-2215
(860) 848-8844
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
005485
CT
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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