| NPI | 1730646571 |
|---|---|
| Doing Business As | LEGACY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | AMANDA LIGHTFOOT Authorized Representative 214-702-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2024-03-04 |