| 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 |