Most Relevant Information
Provider Data
| NPI Number: | 1003426081 |
| Provider Name: | CARSON LACKEY DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 36424 |
Most Important Dates
| Enumeration Date: | 08/05/2020 |
| Last Updated: | 06/15/2021 |
Provider Practice Location
1109 NORTHWEST HWY
GARLAND
TX
750415833
Practice Location Phone/Fax
| Phone: | 2142274863 |
| Fax: |
Provider Mailing Location
2619 MCKINNEY AVE APT 1503
DALLAS
TX
752043059
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |