Individual
DR. LACEY MONTIREY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
8245 S KING DR, CHICAGO, IL 60619-4903
(773) 873-7000
(773) 873-7617
Mailing address
100 E 14TH ST, CHICAGO, IL 60605-2889
(404) 849-6181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027837
IL
Other
Enumeration date
09/05/2006
Last updated
02/26/2009
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