Organization
EDWARD J LACY JR DDS PC
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD J LACY JR. DDS (DENTIST PRESIDENT)
(970) 667-2372
Entity
Organization
Contact information
Practice address
2550 ABARR DR, LOVELAND, CO 80538-3156
(970) 667-2372
Mailing address
2550 ABARR DR, LOVELAND, CO 80538-3156
(970) 667-2372
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5899
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04013942
—
CO
Enumeration date
06/06/2007
Last updated
08/22/2020
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