Edward D. Lacy, Dmd. Fagd, PC

NPI #1043369598 in Tualatin, Oregon

Provider Information

NPI Number: 1043369598
Entity Type: Organization
Organization Name: Edward D. Lacy, Dmd. Fagd, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 10, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 8220 SW WARM SPRINGS ST
Address 2: SUITE 200
City: Tualatin
State: Oregon
ZIP Code: 97062-9097
Phone: (503) 692-0337

Authorized Official

Name: DR. EDWARD D LACY, DMD FAGD
Title: PRESIDENT
Phone: (503) 692-0337

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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