| NPI | 1316835739 |
|---|---|
| Doing Business As | LEGACY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ESTER FAZYLOVA General Dentist 646-510-3787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-30 |