| NPI | 1356186654 |
|---|---|
| Doing Business As | LEGACY DENTAL IMPLANT |
| Other Name | LEGACY DENTAL IMPLANT |
| Entity Type | Organization |
| Authorized Contact | AHMED MATRI Owner 646-824-3829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-06-27 |