| Edward D. Lacy, Dmd. Fagd, Pc | |
|
8220 Sw Warm Springs St Suite 200 Tualatin OR 97062-9097 | |
| (503) 692-0337 | |
| (503) 692-0792 |
| Full Name | Edward D. Lacy, Dmd. Fagd, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8220 Sw Warm Springs St, Tualatin, Oregon |
| Authorized Official Name and Position | Edward D Lacy (PRESIDENT) |
| Authorized Official Contact | 5036920337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward D. Lacy, Dmd. Fagd, Pc 8220 Sw Warm Springs St Suite 200 Tualatin OR 97062-9097 Ph: (503) 692-0337 | Edward D. Lacy, Dmd. Fagd, Pc 8220 Sw Warm Springs St Suite 200 Tualatin OR 97062-9097 Ph: (503) 692-0337 |
| NPI Number | 1043369598 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043369598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D4844 (Oregon) | Primary |
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