Individual
DR. BENJAMIN W LACY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
30 OFFICE PARK DR, PALM COAST, FL 32137-3808
(386) 446-3883
(386) 445-9318
Mailing address
30 OFFICE PARK DR, PALM COAST, FL 32137-3808
(386) 446-3883
(386) 445-9318
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN4347
FL
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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