DR. Lacedric Reitrich Tolliver, D.M.D.

NPI #1972817948 in Fort Worth, Texas

Provider Information

NPI Number: 1972817948
Entity Type: Individual
Name: DR. Lacedric Reitrich Tolliver, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Aug 2, 2010
Last Updated: Aug 11, 2010

Practice Location

Address: 1501 HANDLEY DR
City: Fort Worth
State: Texas
ZIP Code: 76112-3328
Phone: (817) 457-4141

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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