| Edward Lacy Dds | |
|
700 E 9th Ave Unit 102 Denver CO 80203-3360 | |
| (303) 832-7789 | |
| (303) 832-0427 |
| Full Name | Edward Lacy Dds |
|---|---|
| Speciality | Clinic/Center |
| Location | 700 E 9th Ave Unit 102, Denver, Colorado |
| Authorized Official Name and Position | Melody Bennion (DIRECTOR OF INTEGRATIONS) |
| Authorized Official Contact | 4802348490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Lacy Dds 410 N 44th St Ste 290 Phoenix AZ 85008-7622 Ph: (480) 626-4154 | Edward Lacy Dds 700 E 9th Ave Unit 102 Denver CO 80203-3360 Ph: (303) 832-7789 |
| NPI Number | 1992275630 |
|---|---|
| Provider Enumeration Date | 11/26/2018 |
| Last Update Date | 06/27/2023 |
| Medicare PECOS PAC ID | 2567857659 |
|---|---|
| Medicare Enrollment ID | O20220329000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992275630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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