Individual
DR. CHARITY J.E. VANDERWALL-LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
123 COBIA CT, JACKSONVILLE, NC 28546-6862
(910) 347-1211
Mailing address
123 COBIA CT, JACKSONVILLE, NC 28546-6862
(910) 347-1211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10800
NC
122300000X
Dentist
DEN1001627
DC
Other
Enumeration date
06/16/2016
Last updated
07/21/2022
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