Individual
DR. LACEY NICOLE GREENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
307 N 17TH ST, KEOKUK, IA 52632-3419
(319) 524-2728
Mailing address
307 N 17TH ST, KEOKUK, IA 52632-3419
(319) 524-2728
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08720
IA
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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