Organization
SAN JUAN SMILES FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LACEY DMD (OWNER)
(970) 375-7671
Entity
Organization
Contact information
Practice address
2323 W 2ND AVE STE A, DURANGO, CO 81301-4646
(970) 375-7671
(970) 375-1239
Mailing address
2323 W 2ND AVE STE A, DURANGO, CO 81301-4646
(970) 375-7671
(970) 375-1239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8056
CO
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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