| None | |
|
2550 Abarr Dr Loveland CO 80538-3156 | |
| (970) 667-2372 | |
| Not Available |
| Full Name | None |
|---|---|
| Speciality | Dentist |
| Location | 2550 Abarr Dr, Loveland, Colorado |
| Authorized Official Name and Position | Edward J Lacy (DENTIST PRESIDENT) |
| Authorized Official Contact | 9706672372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 2550 Abarr Dr Loveland CO 80538-3156 Ph: (970) 667-2372 | None 2550 Abarr Dr Loveland CO 80538-3156 Ph: (970) 667-2372 |
| NPI Number | 1790988830 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790988830 | NPI | - | NPPES |
| 04013942 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5899 (Colorado) | Primary |
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