Individual
DR. NANCY KATHERINE VON LACKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D., PH.D.
Contact information
Practice address
620 PERIMETER DR, SUITE 103, LEXINGTON, KY 40517-4125
(859) 268-1596
(859) 977-7376
Mailing address
620 PERIMETER DR, SUITE 103, LEXINGTON, KY 40517-4125
(859) 268-1596
(859) 977-7376
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9105
KY
1223P0300X
Periodontics
Primary
923
KY
Other
Enumeration date
11/08/2011
Last updated
08/01/2013
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