NPI | 1053534453 |
---|---|
Doing Business As | LEGACY DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | LOUIS CORE Manager 602-993-4200 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2007-04-11 |
Last Update Date | 2012-11-14 |