Individual
DR. MARK A LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
875 UNION AVE, MEMPHIS, TN 38163-5028
(901) 448-1883
Mailing address
875 UNION AVE, MEMPHIS, TN 38163-1421
(901) 448-1883
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7334
TN
Other
Enumeration date
08/31/2006
Last updated
01/13/2021
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