DR. Lacey Todd Blackwell, DDS

NPI #1063019404 in Midlothian, Virginia

Provider Information

NPI Number: 1063019404
Entity Type: Individual
Name: DR. Lacey Todd Blackwell, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Oct 8, 2020
Last Updated: Oct 8, 2020

Practice Location

Address: 5954 HARBOUR PARK DR
City: Midlothian
State: Virginia
ZIP Code: 23112-2163
Phone: (804) 739-1600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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