Individual
DR. DANA ROBERT LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-2435
Mailing address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-2435
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
28293
OK
2085B0100X
Body Imaging Physician
9901
HI
2085B0100X
Body Imaging Physician
G82305
CA
Other
Enumeration date
01/28/2006
Last updated
10/14/2020
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