| NPI | 1255044723 |
|---|---|
| Doing Business As | LEGACY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | KYLE STEPHEN NOVOTNY Owner 763-757-1323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2022-12-29 |