Individual
MARLENE A LACAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1323 BIA ROUTE 4, FORT THOMPSON, SD 57339-0200
(605) 245-1518
(605) 245-2150
Mailing address
510 N MADISON AVE, PIERRE, SD 57501-2633
(605) 224-9771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
45-710
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5549010
—
SD
Enumeration date
07/18/2006
Last updated
11/29/2011
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