| Lacey Dental, Llc | |
|
1110 Galaxy Dr Ne Lacey WA 98516-4763 | |
| (253) 537-1559 | |
| (253) 536-5907 |
| Full Name | Lacey Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1110 Galaxy Dr Ne, Lacey, Washington |
| Authorized Official Name and Position | Scott Probst (OWNER) |
| Authorized Official Contact | 2535371559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacey Dental, Llc 1110 Galaxy Dr Ne Lacey WA 98516-4763 Ph: (253) 537-1559 | Lacey Dental, Llc 1110 Galaxy Dr Ne Lacey WA 98516-4763 Ph: (253) 537-1559 |
| NPI Number | 1831520162 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831520162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE 60178653 (Washington) | Primary |
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