Provider Demographics
NPI:1205099728
Name:WINFORD, LACEY KATHERINE (DDS)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:KATHERINE
Last Name:WINFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W END AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4917
Mailing Address - Country:US
Mailing Address - Phone:212-595-1500
Mailing Address - Fax:212-202-4823
Practice Address - Street 1:180 W END AVE APT 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4917
Practice Address - Country:US
Practice Address - Phone:212-595-1500
Practice Address - Fax:212-202-4823
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055920122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist