Individual
MORGANNE LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 N TAYLOR AVE, KIRKWOOD, MO 63122-4368
(314) 821-4100
Mailing address
1030 CLAYTONIA TER, SAINT LOUIS, MO 63117-1509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2025019883
MO
Other
Enumeration date
05/12/2023
Last updated
07/02/2025
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