| NPI | 1932316841 |
|---|---|
| Doing Business As | RAY E LACK, DDS |
| Entity Type | Organization |
| Authorized Contact | RYAN BORER Consultant 603-721-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8982) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |