| NPI | 1295277903 |
|---|---|
| Doing Business As | LEGACY DENTAL |
| Entity Type | Organization |
| Authorized Contact | STEWART ANDERSON Partner 505-314-6526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD3103) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2016-11-11 |