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General NPI Number Information
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NPI Number | 1205191004
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Entity Type | Individual
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Provider Name | LACIE DENNIS COLEY DDS
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Gender | Female
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Dates
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Enumeration Date | 07/08/2012
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 2601 BARROW ST
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City | ABILENE
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State | TX
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Zip | 79605-6238
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Country | US
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Telephone | 325-795-8880
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Fax | 325-698-6555
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Provider Business Mailing Address
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Address Line | 2601 BARROW ST
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City | ABILENE
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State | TX
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Zip | 79605-6238
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Country | US
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Telephone | 325-795-8880
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Fax | 325-698-6555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28153
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License Number State | TX
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