Provider Demographics
NPI:1700883923
Name:LACKEE, FRANKLIN CAMERON (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:CAMERON
Last Name:LACKEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 E MAIN ST
Mailing Address - Street 2:SUITE: 202
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2552
Mailing Address - Country:US
Mailing Address - Phone:845-343-1533
Mailing Address - Fax:845-343-2109
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:SUITE: 202
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2552
Practice Address - Country:US
Practice Address - Phone:845-343-1533
Practice Address - Fax:845-343-2109
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist