Individual
BRANDON MICHAEL LACKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3544 BRODHEAD RD, MONACA, PA 15061-3126
(724) 728-1212
Mailing address
122 MOFFETT RUN RD, ALIQUIPPA, PA 15001-9499
(724) 480-7363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043760
PA
Other
Enumeration date
05/08/2022
Last updated
04/05/2025
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